Study of endoscopic surgery for hypertensive cerebral hemorrhage through lateral fissure approach versus frontal keyhole approach
LI Xiaohe
WU Yanbing
ZHANG Yingsong
Abstract：Objective To study the efficacy of endoscopic surgery through the lateral fissure approach versus the frontal keyhole approach for hypertensive cerebral hemorrhage(HCH).Methods A retrospective analysis was conducted on the data of 120 patients with HCH.According to different surgical approaches,they were divided into the lateral fissure group(62 cases,endoscopic surgery through lateral fissure approach)and the frontal keyhole group(58 cases,endoscopic surgery through frontal keyhole approach).The perioperative indexes,the oxidative stress indexes(serum superoxide dismutase[SOD],malondialdehyde[MDA],glutathione peroxidase[GSH-Px]),neurological function(serum S100β protein[S100β],neuron-specific enolase[NSE]),prognosis(Glasgow Outcome Scale[GOS])preoperatively and at 3 days postoperatively,and postoperative complications were compared between the two groups.Results The operation time in the frontal keyhole group was significantly shorter than that in the lateral fissure group(P＜0.05).At 3 days postoperatively,SOD in the both groups was significantly lower than that before operation,and MDA and GSH-Px were significantly higher(P＜0.05).At 3 days postoperatively,S100β and NSE levels in the both groups were significantly decreased than those before operation,the decrease in the frontal keyhole group was more prevalent compared with the lateral fissure group(P＜0.05).At 1 month postoperatively,GOS scores in the both groups were significantly increased than those before operation,the increase in the frontal keyhole group was more common than the lateral fissure group(P＜0.05).Conclusion The endoscopic surgery through lateral fissure approach and frontal keyhole approach can effectively remove intracranial hematoma,but the frontal keyhole approach has advantages in shortening surgery time,reducing intraoperative bleeding,and improving prognosis.
Keywords：hypertensive cerebral hemorrhageendoscopelateral fissure approachfrontal keyhole approach
Publication Date：2025-11-26
Online Publishing Date：2025-12-12(First online date of this platform, not the publication date of the document)
Pages：4( 1819-1822 )