Application of self-made new endoscopic sleeve guided by wire drainage tube in minimally invasive operation of supratentorial deep brain hematoma

This study aimed to examine the clinical effectiveness of a new endoscopic sleeve guided by a custom-made drain and guidewire in minimally invasive surgery for supratentorial deep intracerebral hematoma. This study included 168 individuals diagnosed with supratentorial deep cerebral hemorrhage between January 2019 and January 2023. Patients were divided into two groups based on their treatment plans: those who had hematomas removed using a new endoscopic sleeve guided by a homemade drainage tube with guidewire were included in the Experimental group(n = 84), and those who had hematomas removed using a cranial microscope with a small bone window were included in the control group. Preoperative indices, surgical indices, postoperative complications, discharge outcomes, and prognosis were compared between the two groups. The results found that there were no statistically significant differences between the patients in terms of sex, age, hemorrhage site, preoperative hemorrhage volume (ml), preoperative GCS score, hospital stay, intracranial infection, and epilepsy (P > 0.05). The experimental group was compared with the control group in terms of operative time, intraoperative blood loss, postoperative residual hematoma volume, hematoma clearance rate, and postoperative hematoma-related outcomes. There was a significant difference (P < 0.05) in GCS score at discharge, Rankin score at discharge, and GOS score at 3 months after surgery.The new homemade endoscopic sleeve can reduce collateral damage to brain tissue during sleeve placement, reduce postoperative bleeding from the endoscopic working channel and rebleeding in the operative area, increase the hematoma clearance rate, shorten the operative time, and make endoscopic hematoma removal surgery more precise and minimally invasive.