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Efficacy and safety of neuroendoscopy surgery versus craniotomy for supratentorial intracerebral hemorrhage: an updated meta-analysis of randomized controlled trials.
Monteiro, Gabriel de Almeida; Marinheiro, Gabriel; Mutarelli, Antonio; Araújo, Beatriz; Cavalcante-Neto, Joaquim Francisco; Batista, Sávio; Leal, Paulo Roberto Lacerda; Cristino-Filho, Gerardo; Figueiredo, Eberval Gadelha; Telles, João Paulo Mota.
Afiliação
  • Monteiro GA; Department of Neurosurgery, Federal University of Ceará, Av. Cmte. Maurocélio Rocha Pontes, 100 - Jocely Dantas de Andrade Torres, Sobral - CE, Sobral, 62042-250, Brazil. gabrielmont00@gmail.com.
  • Marinheiro G; School of Medicine, Federal University of Ceará, Sobral, Brazil.
  • Mutarelli A; School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil.
  • Araújo B; Department of Medicine, Nove de Julho University, São Bernado do Campo, Brazil.
  • Cavalcante-Neto JF; Department of Neurosurgery, Federal University of Ceará, Av. Cmte. Maurocélio Rocha Pontes, 100 - Jocely Dantas de Andrade Torres, Sobral - CE, Sobral, 62042-250, Brazil.
  • Batista S; Department of Neurosurgery, Hospital do Servidor Público Estadual, IAMSPE, São Paulo, Brazil.
  • Leal PRL; Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
  • Cristino-Filho G; Department of Neurosurgery, Federal University of Ceará, Av. Cmte. Maurocélio Rocha Pontes, 100 - Jocely Dantas de Andrade Torres, Sobral - CE, Sobral, 62042-250, Brazil.
  • Figueiredo EG; Department of Neurosurgery, Federal University of Ceará, Av. Cmte. Maurocélio Rocha Pontes, 100 - Jocely Dantas de Andrade Torres, Sobral - CE, Sobral, 62042-250, Brazil.
  • Telles JPM; Division of Neurosurgery, University of São Paulo, São Paulo, Brazil.
Neurosurg Rev ; 47(1): 255, 2024 Jun 04.
Article em En | MEDLINE | ID: mdl-38833192
ABSTRACT
Neuroendoscopy (NE) surgery emerged as a promising technique for the treatment of spontaneous intracerebral hemorrhage (ICH). A previous meta-analysis of randomized controlled trials (RCTs) analyzed the efficacy and safety of NE compared to craniotomy, but NE did not present a significant improvement in functional outcomes. However, a new study provided an opportunity to update the current knowledge. We searched PubMed, Embase, and Cochrane Central Register of Controlled Trials for RCTs reporting NE evacuation of spontaneous supratentorial ICH compared to craniotomy. The efficacy outcomes of interest were favorable functional outcome, functional disability, hematoma evacuation rate, and residual hematoma volume. The safety outcomes of interest were rebleeding, infection, and mortality. Seven RCTs were included containing 879 patients. The NE approach presented a significantly higher rate of favorable functional outcome compared with craniotomy (RR 1.42; 95% CI 1.17, 1.73; p < 0.001). The evacuation rate was higher in patients who underwent the NE approach (MD -8.36; 95% CI -12.66, -4.07; p < 0.001). NE did not show a benefit in improving the mortality rate (RR 0.81, 95% CI 0.54, 1.22; p = 0.32). NE was associated with more favorable functional outcomes and lower rates of functional disabilities compared to craniotomy. Also, NE was superior regarding evacuation rate, while presenting a reduction in residual hematoma volume. NE might be associated with lower infection rates. Mortality was not improved by NE surgery. Larger, higher-quality randomized studies are needed to adequately evaluate the efficacy and safety of NE compared to craniotomy.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ensaios Clínicos Controlados Aleatórios como Assunto / Hemorragia Cerebral / Craniotomia / Neuroendoscopia Limite: Humans Idioma: En Revista: Neurosurg Rev Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Alemanha
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ensaios Clínicos Controlados Aleatórios como Assunto / Hemorragia Cerebral / Craniotomia / Neuroendoscopia Limite: Humans Idioma: En Revista: Neurosurg Rev Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Alemanha