Efficacy and safety of minimal invasive surgery treatment in hypertensive intracerebral hemorrhage: a systematic review and meta-analysis
| Autor: | Fengqiong Yin, Xinhai Gao, Zhengchao Lv, Yiping Tang, Dengli Fu, Xuetao Li |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Randomization medicine.medical_treatment Minimal invasive surgery (MIS) Glasgow Outcome Scale Intracranial Hemorrhage Hypertensive lcsh:RC346-429 Neurosurgical Procedures 03 medical and health sciences 0302 clinical medicine Hematoma Hypertensive intracerebral hemorrhage (HICH) Risk Factors medicine Humans Minimally Invasive Surgical Procedures 030212 general & internal medicine lcsh:Neurology. Diseases of the nervous system Craniotomy Conservative method Intracerebral hemorrhage business.industry Mortality rate General Medicine Publication bias medicine.disease Surgery Meta-analysis Treatment Outcome Female Neurology (clinical) business 030217 neurology & neurosurgery Research Article |
| Zdroj: | BMC Neurology BMC Neurology, Vol 18, Iss 1, Pp 1-11 (2018) |
| ISSN: | 1471-2377 |
| Popis: | Background Recently, minimal invasive surgery (MIS) has been applied as a common therapeutic approach for treatment of hypertensive intracerebral hemorrhage (HICH). However, the efficacy and safety of MIS is still controversial compared with conservative medical treatment or conventional craniotomy. This meta-analysis aimed to systematically assess the safety and efficacy of MIS compared with conservative method and craniotomy in treating HICH patients. Methods PubMed, Embase, Web of Science, and Cochrane Controlled Trials Register were used to identify relevant studies on MIS treatment of HICH up to November 2017. This study evaluated Glasgow Outcome Scale (GOS) score, Activities of Daily Living (ADL) score, pulmonary infection rate, mortality rate, and rebleeding rate for patients who underwent MIS, or conservative method, or craniotomy. Subgroup analyses were performed to compare randomization versus non-randomization and large hematoma versus small or mild hematoma. Begg’s test and Egger’s test were used to determine the potential presence of publication bias. Results Sixteen studies consisting of 1912 patients were included in this study to compare the efficacy and safety of MIS to conservative method or craniotomy. MIS contributed to a significant improvement on the prognosis of the patients comparing with conservative group or craniotomy group. Patients undergoing MIS had a lower mortality rate when compared to those receiving conservative method. Also, MIS led to a notable reduction of rebleeding rate and an effective improvement of the patient’s quality of life by contrast with craniotomy. No obvious difference was found in terms of the pulmonary infection rate among the comparisons of three treatment methods. Randomization is not the potential source of heterogeneity, but hematoma volume may be a risk factor for post-operative mortality rate. No statistical evidence of publication bias among studies was found under most of comparison models. Conclusion This meta-analysis suggests that minimal invasive surgery is an efficient and safe method for the treatment of hypertensive intracerebral hemorrhage, which is associated with a low mortality rate and rebleeding rate, as well as a significant improvement of the prognosis and the quality life of patients when compared with conservative medical treatment or craniotomy. |
| Databáze: | OpenAIRE |
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