Study on the efficacy and technical details of endoscopic surgery in basal ganglia hemorrhage

LI Ming; FAN Xuezheng; HU Zhiqing; LIN Chaoqun; YI Jianbo; QIU Bo

Abstract：Objective The clinical effect and technical details of endoscopic surgery in basal ganglia hemorrhage were discussed and summarized.Methods The clinical data of 49 cases of cerebral hemorrhage in basal ganglia from June 2015 to January 2016 were analyzed retrospectively and the technical details including selection of fistulization location,the direction of working channels,the bleeding prevention,and the hemostatic ways under endoscopy.Results The mean blood loss was (101.03 ±21.30) mL,the mean operation time was (62.12 ±9.29) main,the skin incision was (5.02 ±0.37) cm,and the bone window size was (6.65 ±0.31) cm2.Post-operative CT scan within 24 h was performed in 49 cases,which confirmed that the hematomas were evacuated totally in 43 cases,a small amount of residual in 5 cases,and 1 case failed to recheck CT.There were 46 survival cases and 3 death cases,in which 1 case died of brainstem function failure,1 of pulmonary infection,and 1 of gastrointestinal bleeding.All these 46 survival cases were followed up for more than 6 months.According to the activity of daily living,there were 19 cases of Grade Ⅰ,17 cases of Grade Ⅱ,5 cases of Grade Ⅲ and 5 cases of Grade Ⅳ.Conclusion Endoscopic treatment is a minimally invasive,safe and effective method for basal ganglia hemorrhage.The appropriate fistulization place,working channels along the direction of hematora long axis and careful operation could completely remove the hematoma and reduce the surgical injury to the maximum.Pre-operative and intra-operative bleeding prevention can reduce the hemorrhage during operation.The method of aspirator combined with endoscope is simple and practical,so it is worthy of popularization in clinical practices.