Objective:

To evaluate the learning curve of neuroendoscopic evacuation for basal ganglia hemorrhage and to determine the number of cases required to achieve technical proficiency.

Approach:

Key Findings:

• CUSUManalysisidentifiedalearninginflectionpointatapproximatelythe25thcase.Operativetimedecreasedsignificantlyacrossphases(1.77±0.47hvs.1.28±0.40hvs.1.23±0.42h,P<0.01).Hematomaevacuationrateincreasedsignificantly(84.90%±3.59%vs.93.27%±3.65%vs.92.92%±3.41%,P<0.01).Mostsurgicalperformanceindicatorsimprovedsignificantlybetweentheinitialandproficiencyphases,withnosignificantdifferencesobservedbetweenthelaterphases,indicatingperformancestabilization.Additionally,theuseofelectrocoagulationandhemostaticmaterialsdecreasedsignificantly,accompaniedbyimprovementsinpostoperativeimagingindicatorsandareductioninoverallcomplicationrates(P=0.005).

Interpretation:

Significant differences exist in neuroendoscopic evacuation of basal ganglia hematomas across different learning phases.

Limitations:

• The study is limited to a single center and a single experienced surgeon, which may affect generalizability.
• The retrospective nature of the study may introduce biases.

Conclusion:

These findings can provide guiding value for clinicians to improve surgical efficiency and quality.

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