Efficacy and Safety of Minimally Invasive Neuroendoscopic Surgery in the Therapy of Supratentorial Hypertensive Intracerebral Hemorrhage: A Meta-Analysis

Abstract

Objective: To systematically investigate the therapeutic effects of neuroendoscopic (NE) surgery in supratentorial hypertensive intracerebral hemorrhage (HICH), including key indicators such as hematoma evacuation rate, complications, and neurological prognosis, thus comprehensively understanding the superiority of NE surgery in supratentorial HICH therapy, and to provide scientific basis and decision-making support for clinical practice. Methods: The PubMed, EMBASE, Cochrane, Google, and CNKI databases were searched for relevant literature related to NE surgery for supratentorial HICH published before October 2023. Summary analyses of hematoma evacuation rate, mortality, clinical treatment, good functional outcome (Glasgow Outcome Scale, Glasgow Coma Scale, and modified Rankin Scale), and postoperative complications in the NE group were performed, and Revman 5.3 was used to conduct the meta-analysis. Results: Fourteen trials with 1266 patients were enrolled in this meta-analysis, with an overall moderate risk of bias. Compared with craniotomy, NE-treated patients had a higher rate of cerebral hematoma evacuation, and their operative time, intraoperative blood loss, and hospital stay were markedly reduced. Moreover, NE surgery could better restore patients’ neurological function and autonomy, presenting a higher Glasgow Outcome Scale, Glasgow Coma Scale, and a lower modified Rankin Scale. Moreover, NE surgery effectively reduced the incidence of mortality and postoperative complications, especially rebleeding and lung infection. Conclusion: Neuroendoscopic surgery not only better removes intracranial hematomas and improves neurological function and autonomy in supratentorial HICH patients, but also effectively reduces mortality and postoperative complications.