Turkish neurosurgery · 2024
Nonacute Subdural Hematoma Evacuation Using a Rigid Endoscopy System: A Clinical Study.
СтатьяНазвание и аннотация: Перевод в очереди
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Egemen Emrah, Dere Umit Akin, Celtikci Emrah, Nehir Ali, Dogruel Yucel, Sahinoglu Defne, Asar Rasim, Bakirarar Batuhan, Albuz Baris, Coskun Mehmet Erdal, Yakar Fatih
Аннотация
AIM: To determine the clinical relevance of a rigid endoscopy surgical method for subdural hematomas, as previously described in a cadaver study.
MATERIAL AND METHODS: Between May 2021 and September 2023, 21 patients underwent subdural hematoma drainage using a 0-degree rigid endoscope. Traumatic acute subdural hematomas were excluded. The demographic data of the patients, antiplatelet/ antiaggregant use, perioperative findings, and pre- and post-surgery modified Rankin Scale (mRS) scores were recorded and analyzed.
RESULTS: The mean age of our cohort was 65.63 (±20.52), and the male/ female ratio was 3.2: 1. The hematoma was unilateral in 90.5% of the patients, and the rate of trauma history was 42.9%. The most common radiological diagnosis was chronic subdural hematoma with septa (61.9%). The percentage of patients with a history of antiplatelet/ antiaggregant therapy was 23.8%. No mortality related to the surgery was observed in the early postoperative period; however, two patients underwent reoperation for further bleeding. The neurological grade was the only preoperative factor that had a statistically significant effect on the mRS score at discharge, with significantly better discharge mRS scores in grade 1 and 2 patients (p=0.014).
CONCLUSION: The procedure was found to be safe and feasible, with surgery-related morbidity and mortality within acceptable limits.
MATERIAL AND METHODS: Between May 2021 and September 2023, 21 patients underwent subdural hematoma drainage using a 0-degree rigid endoscope. Traumatic acute subdural hematomas were excluded. The demographic data of the patients, antiplatelet/ antiaggregant use, perioperative findings, and pre- and post-surgery modified Rankin Scale (mRS) scores were recorded and analyzed.
RESULTS: The mean age of our cohort was 65.63 (±20.52), and the male/ female ratio was 3.2: 1. The hematoma was unilateral in 90.5% of the patients, and the rate of trauma history was 42.9%. The most common radiological diagnosis was chronic subdural hematoma with septa (61.9%). The percentage of patients with a history of antiplatelet/ antiaggregant therapy was 23.8%. No mortality related to the surgery was observed in the early postoperative period; however, two patients underwent reoperation for further bleeding. The neurological grade was the only preoperative factor that had a statistically significant effect on the mRS score at discharge, with significantly better discharge mRS scores in grade 1 and 2 patients (p=0.014).
CONCLUSION: The procedure was found to be safe and feasible, with surgery-related morbidity and mortality within acceptable limits.