https://scholars.lib.ntu.edu.tw/handle/123456789/479611
Title: | Local hemostatic matrix for endoscope-assisted removal of intracerebral hemorrhage is safe and effective | Authors: | Luh, Hui-Tzung ABEL PO-HAO HUANG SHIH-HUNG YANG Chen, Chien-Ming Cho, Der-Yang Chen, Chun-Chung LU-TING KUO Li, Chieh-Hsun KUO-CHUAN WANG Tseng, Wei-Lung Hsing, Ming-Tai Yang, Bing-Shiang DAR-MING LAI JUI-CHANG TSAI |
Issue Date: | 2018 | Publisher: | Elsevier B.V. | Journal Volume: | 117 | Journal Issue: | 1 | Start page/Pages: | 63 | Source: | Journal of the Formosan Medical Association | Abstract: | Background/Purpose: Minimally invasive endoscope-assisted (MIE) evacuation of spontaneous intracerebral hemorrhage (ICH) is simple and effective, but the limited working space may hinder meticulous hemostasis and might lead to rebleeding. Management of intraoperative hemorrhage is therefore a critical issue of this study. This study presents experience in the treatment of patients with various types of ICH by MIE evacuation followed by direct local injection of FloSeal Hemostatic Matrix (Baxter Healthcare Corp, Fremont, CA, USA) for hemostasis. Methods: The retrospective nonrandomized clinical and radiology-based analysis enrolled 42 patients treated with MIE evacuation of ICH followed by direct local injection of FloSeal Hemostatic Matrix. Rebleeding, morbidity, and mortality were the primary endpoints. The percentage of hematoma evacuated was calculated from the pre- and postoperative brain computed tomography (CT) scans. Extended Glasgow Outcome Scale (GOSE) was evaluated at 6 months postoperatively. Results: Forty-two ICH patients were included in this study, among these, 23 patients were putaminal hemorrhage, 16 were thalamic ICH, and the other three were subcortical type. Surgery-related mortality was 2.4%. The average percentage of hematoma evacuated was 80.8%, and the rebleeding rate was 4.8%. The mean operative time was 102.7 minutes and the average blood loss was 84.9 mL. The mean postoperative GOSE score was 4.55 at 6-months' follow-up. Conclusion: This study shows that local application of FloSeal Hemostatic Matrix is safe and effective for hemostasis during MIE evacuation of ICH. In our experience, this shortens the operation time, especially in cases with intraoperative bleeding. A large, prospective, randomized trial is needed to confirm the findings. ? 2017 |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85016074614&doi=10.1016%2fj.jfma.2017.02.016&partnerID=40&md5=5cb9efd654f3c9192794b3475a6846ef https://scholars.lib.ntu.edu.tw/handle/123456789/479611 |
ISSN: | 0929-6646 | DOI: | 10.1016/j.jfma.2017.02.016 | SDG/Keyword: | hemostatic agent; sealant; FloSeal Matrix; gelatin sponge; hemostatic agent; adult; aged; Article; basal ganglion hemorrhage; brain hematoma; brain hemorrhage; brain stem; clinical article; controlled study; endoscopic surgery; female; follow up; Glasgow outcome scale; hemiparesis; hemiplegia; hemostatic technique; human; male; middle aged; minimally invasive surgery; morbidity; mortality rate; operation duration; operative blood loss; personal experience; pneumonia; postoperative infection; postoperative period; putaminal hemorrhage; retrospective study; sepsis; surgical mortality; thalamus disease; urinary tract infection; brain hemorrhage; clinical trial; complication; epidemiology; Glasgow coma scale; hematoma; mortality; multicenter study; neuroendoscopy; procedures; Taiwan; treatment outcome; Adult; Aged; Blood Loss, Surgical; Cerebral Hemorrhage; Female; Gelatin Sponge, Absorbable; Glasgow Coma Scale; Hematoma; Hemostatics; Humans; Male; Middle Aged; Neuroendoscopy; Operative Time; Retrospective Studies; Taiwan; Treatment Outcome |
Appears in Collections: | 醫學系 |
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