Modified Flexible Endoscopic Techniques For The Treatment Of Chronic Subdural Haematoma

Objective: To complete a retrospective comparison of modified flexible endoscopic techniques(MFET)and burr-hole craniostomy(BHC)in the treatment of chronic subdural haematoma(CSDH).Methods: A retrospective cohort study comparing MFET and BHC of CSDH was performed.Data of patients with CSDH where either MFET or BHC were performed during the period from June 2013 to June 2020 were retrospectively collected and analysed.Of 91 patients,55 underwent MFET and 39 were treated by BHC.The primary outcome measures were recurrence rate,mortality,morbidity,neurological deficit and modified Rankin scale(m RS)score at first postoperative day,discharge,and 6months.The secondary outcome measures were the operation duration,the placement time of drainage catheter,the length of hospital stay,haematoma evacuation rate,cerebral hemisphere restoration rate,and shifted midline restoration rate at the first postoperative day and discharge.Results: The recurrence rate was significantly lower in the MFET group(1/52,0%)than in the BHC group(5/39,12.8%)(P = 0.038).The rate of morbidity was significantly lower in the MFET group(5/52,9.6%)than in the BHC group(11/33,28.2%)(P = 0.033).The median haematoma evacuation rates and the mean or median cerebral hemisphere restoration rate were significantly higher in the MFET group than in the BHC group at first postoperative day and at discharge(P < 0.05).The median operation duration was significantly longer in the MFET group than in the BHC group(P < 0.05).No statistically significant difference was observed between the two groups in the mortality,neurological deficit and m RS score at first postoperative day,discharge and 6 months,and other secondary outcome measures(P > 0.05).