Stroke (Hoboken, N.J.) · 2026
Full Visualization of Contact Endoscopy for Basal Ganglia Hemorrhage: A Multicenter Retrospective Study Comparing With Microscopy and Neuroendoscopy.
СтатьяНазвание и аннотация: Перевод в очереди
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Ni Shaofei, Duan Aojie, Liu Jiachen, Zheng Yanni, Ren Yubo, Shou Renjie, Wang Fei, Wang Zixuan, Huang Rui, Zhang Li, Gao Shan, Zhou Linqiang, Zhou Qiang, Liu Yanfei, Tan Weiguo, Yan Xigang, Chen Zhouqing, Lu Dengfeng, Yang Boyu, Wang Jing, Sun Xiaoou, Wang Zhong
Аннотация
BACKGROUND: Basal ganglia hemorrhage (BGH) is a severe subtype of spontaneous intracerebral hemorrhage. Surgical intervention remains a critical strategy for reducing hematoma volume, alleviating mass effect, and improving clinical outcomes. This study compared fully visualized contact endoscopy with microscopy and standard neuroendoscopy for BGH treatment.
METHODS: A retrospective, multicenter, observational cohort study was conducted on patients undergoing surgical evacuation for BGH (n=335) at 8 tertiary medical centers in Suzhou from January 2021 to May 2024, stratified into microscopy (n=217), neuroendoscopy (n=76), and contact endoscopy (n=42) groups. Surgical outcomes and prognostic indicators were systematically evaluated across groups, with multivariable analysis conducted to independently assess the impact of surgical methods on long-term prognosis.
RESULTS: Both endoscopic groups showed significantly shorter operation times, reduced blood loss, and shorter intensive care unit stays than the microscopy group (P<0.05), with no difference between endoscopic techniques. Endoscopy was associated with lower intracranial infection rates (P<0.0167). There were no significant differences in hematoma evacuation rates, neurological scores at 7 days, or functional outcomes (both Glasgow Outcome Scale scores and Karnofsky Performance Status scores) at 3 months. Multivariable analysis identified older age, hypertension, and larger hematoma volume, but not surgical technique, as independent predictors of poor long-term outcome.
CONCLUSIONS: Microscopy, neuroendoscopy, and contact endoscopy all demonstrated effectiveness for hematoma evacuation and life preservation for BGH. Endoscopic approaches may offer superior perioperative safety profiles without significant long-term outcome differences. Contact endoscopy is a safe and feasible alternative for BGH surgery.
METHODS: A retrospective, multicenter, observational cohort study was conducted on patients undergoing surgical evacuation for BGH (n=335) at 8 tertiary medical centers in Suzhou from January 2021 to May 2024, stratified into microscopy (n=217), neuroendoscopy (n=76), and contact endoscopy (n=42) groups. Surgical outcomes and prognostic indicators were systematically evaluated across groups, with multivariable analysis conducted to independently assess the impact of surgical methods on long-term prognosis.
RESULTS: Both endoscopic groups showed significantly shorter operation times, reduced blood loss, and shorter intensive care unit stays than the microscopy group (P<0.05), with no difference between endoscopic techniques. Endoscopy was associated with lower intracranial infection rates (P<0.0167). There were no significant differences in hematoma evacuation rates, neurological scores at 7 days, or functional outcomes (both Glasgow Outcome Scale scores and Karnofsky Performance Status scores) at 3 months. Multivariable analysis identified older age, hypertension, and larger hematoma volume, but not surgical technique, as independent predictors of poor long-term outcome.
CONCLUSIONS: Microscopy, neuroendoscopy, and contact endoscopy all demonstrated effectiveness for hematoma evacuation and life preservation for BGH. Endoscopic approaches may offer superior perioperative safety profiles without significant long-term outcome differences. Contact endoscopy is a safe and feasible alternative for BGH surgery.