Effects of minimally invasive approaches on chronic subdural hematoma by novel YL-1 puncture needle and burr-hole methods

Abstract

The objective of this study is to investigate effects of minimally invasive approaches on outcome of chronic subdural hematoma (CSDH) by novel YL-1 puncture needle and burr-hole methods. A retrospective analysis was performed in 158 hospitalized CSDH patients from January, 2013 to December, 2017 in Kunshan Hospital of Traditional Chinese Medicine. Patients' gender, age, history of trauma, volume of hematoma, hematoma location, application of urokinase, surgical approach, the operation time, hospitalized time, and CT scans 3 months after discharge were recorded. Prognostic indicators including symptom relief and post-hospital neuro-imaging findings were extracted to evaluate surgical efficacy. Statistical methods were conducted to evaluate surgical efficacy. Both YL-1 puncture needle and burr-hole surgeries had a satisfying follow-up (93.67%). There was non-significant group difference in follow-up results (p > 0.05). While YL-1 needle group needs less operation time ((p < 0.001) and hospitalized time (p < 0.001), gender (p = 0.144), age (p = 0.394), history of head trauma (p = 0.445), volume of hematoma (p = 0.068), hematoma location (p = 0.281), and application of urokinase (p = 0.545) were shown non-significantly associated with these two minimally invasive approaches. Volume of hematoma was significantly associated with follow-up outcomes (p = 0.016). Novel YL-1 puncture needle and classic burr-hole craniotomy are both proved to be safe and effective minimally invasive surgeries, which can provide an early intervention and minimally invasive strategy for neurosurgeons.

Minimally Invasive Surgery in Chronic Subdural Hematoma: Prognosis and Recurrence Factors of 516 Cases in a Single Center

“…Due to the progressive hematomas of CSDH, surgical treatments are still the main solutions for those with symptoms of increased ICP or brain compression. In order to achieve an MIS treatment and good clinical recovery, multiple modified methods were applied in practice work, in which the novel YL-1 hollow needle aspiration drainage system had been proved to be not obviously different from burr-hole craniotomy in the curative effects of CSDH [ 2 , 11 ]. The technique of the YL-1 puncture needle has been introduced and widely used in the center of the Northern Jiangsu People’s Hospital.…”

“…Less residual hematoma volume may result in the chance of an early cure. In addition, atorvastatin has been proved to be safe and effective in conservative patients [ 2 , 19 ]. However, it is still controversial as to whether oral atorvastatin is of benefit to the prevention of recurrence after surgery.…”

“…Chronic subdural hematoma (CSDH) is a common clinical disease treated by neurosurgeons. The incidence is about 14.1 of 100,000 per year in the general population [ 1 , 2 ]. Males represent approximately 75% of the cases, and two-thirds have a clear history of trauma [ 3 ].…”

Effect of Twist-Drill Craniostomy With Hollow Screws for Evacuation of Chronic Subdural Hematoma: A Meta-Analysis

“…A total of 1,369 studies were obtained in the initial search, and 20 studies (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32) were finally included based on the inclusion and exclusion criteria. These 20 studies included 17 English articles (13)(14)(15)(16)(17)(18)(19)(20)(24)(25)(26)(27)(28)(29)(30)(31)(32) and 3 Chinese articles (21)(22)(23), of which four of them were randomized controlled trials (15,17,20,21) while the remaining 16 were case-control trials. The workflow of literature retrieval and screening is shown in Figure 1.…”

Clinical efficacy of minimally invasive puncture and drainage versus trepanation and drainage for chronic subdural hematoma: Systematic review and meta-analysis

“…Of course, it may also be caused by the inconsistent follow-up time after operation. For example, the recurrence rate calculated by Xu et al [18] was the recurrence within 1 year after operation, while Horn et al [13] only carried out a follow-up investigation for 3 months. In view of this situation, we will carry out clinical trials as soon as possible for analysis and confirmation.…”