Published online Jun 6, 2022. doi: 10.12998/wjcc.v10.i16.5208
Peer-review started: August 8, 2021
First decision: January 10, 2022
Revised: January 19, 2022
Accepted: April 2, 2022
Article in press: April 2, 2022
Published online: June 6, 2022
Processing time: 297 Days and 21.5 Hours
Intraventricular hemorrhage (IVH) is a neurosurgical emergency, and a dangerous condition associated with high morbidity and mortality. In traditional treatment, hematoma evacuation is generally executed by external intracranial drainage (EVD) or surgical evacuation,but endoscopic evacuation is emerging as a good alternative approach, which brings relatively less invasion and injury. Accordingly, we need more successful endoscopic evacuation skilled experience to support endoscopic evacuation deve
With the development of endoscopic evacuation approach in Intraventricular hemorrhage therapy,we need more successful endoscopic evacuation skilled manipulation of endoscopic devices and the evidence supporting its efficacy differs. Thus, in this research, we retrospectively studied 96 consecutive patients with intraventricular hemorrhage who underwent either endoscopic surgery or non-endoscopic surgery for hemorrhage evacuation in different reports, which could provide guidance for endoscopic evacuation treatment in IVH.
In this research, we try to improve the technique usage and provide more evidence of endoscopic evacuation efficacy. Besides, we summarize our surgical experience and compared the outcomes of the endoscopic evacuation with EVD using real-world data.
We retrospectively studied 96 consecutive patients with intraventricular hemorrhage who underwent either endoscopic surgery (n = 43) or non-endoscopic surgery (n = 53) for hemorrhage evacuation between November 2013 and September 2019 in our center. Patients’ conditions prior to and after the operation were evaluated and analyzed to assess the efficacy of the operation. The consciousness status improvement and perioperative in-hospital parameters in the two types of operation groups were assessed and compared.
Patients in the endoscopic and non-endoscopic groups presented with a similar state of consciousness, with a comparable Glasgow Coma Scale (GCS) index. It was found that the average operation time was longer in the endoscopic group; the endoscopic group had a baseline Graeb score that indicated more severe hemorrhage than the non-endoscopic group, and the clearance rate of hematoma was as high as 60.5%. In the endoscopic group, the improved GCS index was more marked. Besides, the intensive care unit stay of the endoscopic group was significantly shorter than that of the non-endoscopic group.
Endoscopic evacuation of intraventricular hemorrhage was generally an effective and efficient way for hemorrhage evacuation, and contributed remarkably to the improvement of consciousness in patients with intraventricular hemorrhage, which could be a potential surgical methods to be developed.
In our retrospective analysis, our study showed that endoscopic evacuation of IVH was generally effective and efficient. The included patients showed significant improvement in consciousness, long-term recovery, and the Graeb index. This research provides us more preliminary experience in practicing endoscopic evacuation.