ArticleBMC surgery2025
Effectiveness of 3D-Slicer simulated neuro-navigation assisted minimally invasive neuro-endoscopic surgery for basal ganglia hypertensive intracerebral hemorrhage.
Article in BMC surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThe study aimed to compare the effectiveness of endoscopic surgery assisted by 3D-Slicer with traditional craniotomy for treating basal ganglia hypertensive intracerebral hemorrhage (HICH).
methodsA total of 133 individuals diagnosed with hypertensive intracerebral hemorrhage in the basal ganglia region underwent surgical intervention in the Department of Neurosurgery at Affiliated Changshu Hospital of Nantong University from January 2018 to June 2023. Based on the surgical approach, participants were categorized into two cohorts: 76 patients who underwent endoscopic procedures and 57 who received traditional craniotomy. Postoperative hematoma clearance rates were quantified through volumetric analysis using 3D-Slicer software. Additionally, intergroup analyses were conducted to evaluate differences in surgical duration, hemorrhage volume during operation, Glasgow Coma Scale assessments at postoperative day 7, length of hospital stay and modified Rankin Scale score 3 months after surgery.
resultsThere were no statistically significant differences in preoperative baseline characteristics between the endoscopy and craniotomy groups (p > 0.05). However, the endoscopy group demonstrated superior surgical and clinical outcomes compared to the craniotomy group. Specifically, the endoscopy group achieved a significantly higher hematoma evacuation rate (90.0% ± 3.9% vs. 82.8% ± 4.9%, p < 0.01), a shorter operative time (1.5 ± 0.8 h vs. 4.9 ± 1.6 h, p < 0.01), and significantly reduced intraoperative blood loss (91.9 ± 89.1 mL vs. 593.6 ± 592.3 mL, p < 0.01). Postoperatively, the endoscopy group exhibited better neurological function, as indicated by higher Glasgow Coma Scale (GCS) scores (10.5 ± 2.3 vs. 7.9 ± 3.4, p < 0.01), and a shorter hospital stay (10.6 ± 5.8 days vs. 13.4 ± 8.2 days, p < 0.05). Postoperative modified Rankin Scale (mRS) score at 3 months were significantly better in the endoscopy group (3.4 ± 1.4 vs. 4.3 ± 1.7, p < 0.01) than in the craniotomy group. Endoscopic surgery was associated with more favorable outcomes, including higher hematoma clearance, reduced surgical duration and blood loss, improved neurological recovery, and faster postoperative rehabilitation compared to craniotomy. Data are presented as mean ± SD.
conclusionsEndoscopic procedures demonstrate superior clinical outcomes compared with conventional craniotomy for managing hypertensive intracerebral hemorrhage in the basal ganglia region, potentially enhancing patient recovery. This minimally invasive technique represents an advanced therapeutic approach for such cases. As endoscopic technology continues to evolve, its application in neurosurgical practice is expected to expand significantly. However, further validation through prospective randomized controlled studies remains essential to establish its efficacy conclusively.
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