Flexible endoscope-assisted evacuation of chronic subdural hematomas
Jazyk angličtina Země Rakousko Médium print-electronic
Typ dokumentu časopisecké články
PubMed
27473394
DOI
10.1007/s00701-016-2902-5
PII: 10.1007/s00701-016-2902-5
Knihovny.cz E-zdroje
- Klíčová slova
- Burr hole, Chronic subdural hematoma, Endoscopic surgery, Head trauma, Minimally invasive neurosurgery, Neuroendoscopy,
- MeSH
- bolesti hlavy etiologie MeSH
- chronický subdurální hematom chirurgie MeSH
- dospělí MeSH
- drenáž metody MeSH
- endoskopie přístrojové vybavení metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- miniinvazivní chirurgické výkony metody MeSH
- pooperační komplikace MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- subdurální prostor chirurgie MeSH
- trepanace metody MeSH
- vědomí MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Chronic subdural hematoma (CSDH) is a common neurosurgical condition with an increasing incidence. Standard treatment of CSDHs is surgical evacuation. The objective of this study is to present a modification of standard burr-hole hematoma evacuation using a flexible endoscope and to assess the advantages and risks. METHODS: Prospectively, 34 consecutive patients diagnosed with CSDH were included in the study. Epidemiological, clinical and radiographical data were collected and reviewed. All patients underwent a burr-hole evacuation of CSDH. A flexible endoscope was inserted and subdural space inspected during surgery. The surgeon was looking specifically for the presence of septations, draining catheter position and acute bleeding. RESULTS: Thirty-four patients underwent 37 endoscope-assisted surgeries. Presenting symptoms were hemiparesis (79%), decreased level of consciousness (18%), gait disturbances (15%), headache (12%), aphasia (6%), cognitive disturbances (6%) and epileptic seizure (3%). Average operative time was 43 min, and the average increase in operative time due to the use of the endoscope was 6 min. Recurrence rate was 8.8%, and clinical outcome was favorable (defined as mRS ≤ 2) in 97% of the cases. CONCLUSIONS: To our knowledge, the present cohort of 34 patients is the largest group of patients with CSDH treated using an endoscope. This technique allows decent visualization of the hematoma cavity while retaining the advantages of a minimally invasive approach under a local anesthesia. The main advantages are correct positioning of the catheter under visual control, identification of septations and early detection of cortex or vessel injury during surgery.
Citace poskytuje Crossref.org
Minimally invasive evacuation of chronic subdural hematoma: Repurposing a spinal rigid endoscope
