To evaluate the perioperative results of endoscopic-assisted evacuation compared to burr-hole drainage techniques in chronic subdural hematoma (CSDH), emphasizing the comparative aspect.
Key Findings:
Endoscopic-assisted evacuation resulted in significantly lower residual hematoma rates (35.00% vs. 54.78%, p = 0.0255).
Enhanced neurological outcomes were observed in the endoscopic group (odds ratio 0.30, 95% CI: 0.12–0.63, p = 0.0021).
Endoscopic procedures had longer operative times (average 40.12 min longer, p < 0.0001) and higher hospitalization costs (average ¥9,600 more, p < 0.0001).
Postoperative complication rates were similar between both groups.
Interpretation:
Endoscopic-assisted evacuation offers better hematoma removal and neurological recovery without increasing postoperative complications; however, its higher costs may limit accessibility and impact clinical decision-making.
Limitations:
Single-center study may limit generalizability and applicability to broader populations.
Retrospective design may introduce selection bias, affecting the reliability of the findings.
Conclusion:
Endoscopic-assisted evacuation is more effective in managing CSDH compared to burr-hole drainage, though its cost may restrict its use in some settings, highlighting the need for careful consideration in clinical practice.
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