Heron-mouth neuroendoscopic sheath-assisted neuroendoscopy plays critical roles in treating hypertensive intraventricular hemorrhage

Jie Xu; Siyuan Ma; Weijiang Wu; Wenfeng Fang; Aihua Zhu; Chun Ge; Hua Lu

doi:10.5114/wiitm.2020.99351

Heron-mouth neuroendoscopic sheath-assisted neuroendoscopy plays critical roles in treating hypertensive intraventricular hemorrhage

Wideochir Inne Tech Maloinwazyjne. 2021 Mar;16(1):199-210. doi: 10.5114/wiitm.2020.99351. Epub 2020 Sep 25.

Authors

Jie Xu¹, Siyuan Ma¹, Weijiang Wu¹, Wenfeng Fang¹, Aihua Zhu¹, Chun Ge¹, Hua Lu¹

Affiliation

¹ Department of Neurosurgery, Affiliated Hospital of Jiangnan University (Wuxi Third People's Hospital), Wuxi, China.

Abstract

Introduction: Neuroendoscopy is widely applied for treating hypertensive intracerebral hemorrhage.

Aim: To explore the effects of heron-mouth neuroendoscopic sheath-assisted neuroendoscopy on treatment of hypertensive intraventricular hemorrhage.

Material and methods: A type of heron-mouth neuroendoscopic sheath combining the advantages of minimally invasive columnar endoscopic sheath and open operation methods was designed. The end of sheath catheter could be dilated if necessary, without increasing risk of cortex injury. Heron-mouth neuroendoscopic sheath-assisted neuroendoscopy was applied in treatment of hypertensive intraventricular hemorrhage. A total of 19 patients with hypertensive intraventricular hemorrhage were selected and divided into an external ventricular drainage + urokinase group and a neuroendoscopy group. Hematoma clearance rate, surgical time, ventricular drainage time, intracranial infection, hydrocephalus and Glasgow Outcome Score (GOS) at 3 months after the operation were compared between two groups.

Results: Hematoma clearance rate, ventricular drainage time, mortality rate and GOS at 3 months after surgery in the neuroendoscopy group were significantly better compared to those in the external ventricular drainage + urokinase group (p < 0.05). Postoperative complications, including intracranial infection hydrocephalus and pulmonary infection in the neuroendoscopy group, were less numerous compared to those in the external ventricular drainage + urokinase group, but without statistical significance (p > 0.05). However, surgical time was significantly longer in the neuroendoscopy group compared to that in the external ventricular drainage + urokinase group (p < 0.05). There was no significant difference in incidence rate of hydrocephalus between the two groups (p > 0.05).

Conclusions: Clinical effects of heron-mouth neuroendoscopic sheath-assisted neuroendoscopy were better than those of external ventricular drainage combining urokinase dissolution in treating hypertensive intraventricular hemorrhage.

Keywords: hematoma; heron-mouth neuroendoscopic sheath; hypertensive intraventricular hemorrhage; neuroendoscopy.