World Neurosurg. 2023 Oct 20:S1878-8750(23)01480-8. doi: 10.1016/j.wneu.2023.10.076. Online ahead of print.
OBJECTIVES: To compare the efficacy of neuroendoscopic hematoma evacuation (NHE) and burr hole craniotomy (BHC) for treating Septated chronic subdural hematoma (sCSDH) and analyze the technical advantages of NHE in sCSDH treatment by data anylise.
METHODS: This study recruited 77 patients with sCSDH According to the type of operation, the patients were divided into NHE (n = 45) or BHC (n = 32) groups. Clinical data were retrospectively analyzed to evaluate and compare the efficacy of NHE and BHC for treating sCSDH.
RESULTS: NHE demonstrated higher complete hematoma clearance and postoperative midline recovery rates and shorter subdural drainage and postoperative bed rest durations compared with BHC (P < 0.05). The average NHE time (72.27 ± 18.27 min) was longer than that of BHC (54.91 ± 16.04 min) (P < 0.05). The average follow-up period was 30.9 (range, 7-51) months. The results revealed that 1 and 12 cases recurred in the NHE (2.2%) and BHC (18.8%) groups, respectively (P < 0.05). Additionally, a statistically significant difference in the Modified Rankin Scale scores of the two groups was observed 6 months after the operation (P < 0.05). During the follow-up period, neither group demonstrated any obvious operative complications.
CONCLUSION: NHE is more effective than BHC for treating sCSDH and is worth popularizing on a large scale; however, ways to better deal with the outer membrane of hematoma warrant further consideration.