Comparative study of surgical treatment of hypertensive intracerebral hemorrhage assisted with ROSA system and stereotactic frame

Objective To compare the surgical outcome of intracerebral hematoma drilling and drainage for hypertensive intracerebral hemorrhage (HICH) using robotized stereotactic assistant(ROSA)-assisted and stereotactic framework. Methods A retrospective study was conducted on 368 patients with HICH who underwent hematoma drilling at Department of Neurosurgery, General Hospital of Shenyang Military Command from March 2015 to April 2017. According to the surgical method, all cases were divided into the stereotactic frame group (group A) and ROSA group (group B). Comparison was conducted on the treatment outcome of those 2 surgical methods for HICH. Results There was no statistically significant difference in gender, age, preoperative GCS (Glasgow coma scale), time interval from bleeding to operation and bleeding volume between 2 groups (all P>0.05). The operating time (27.3±8.4 min) and incidence of rebleeding (1.7%, 3/172) were lower in group B than those in group A [operation time: (44.2±7.7) min, incidence of rebleeding: 8.7% (17/196)] (both P<0.01). In group A, 12 (6.1%) patients developed postoperative intracranial infection and none had intracranial infection in group B and there was statistically significant difference between the 2 groups (P=0.001). The extubation time in groups A and B was (2.5±0.7) days and (1.2±0.5) days post opeartion, respectively, which were significantly different (P<0.001). The 30-day mortality rate in group B (2.3%, 4/172) was lower than that in group A (9.2%, 18/196) (P=0.006). Conclusion Compared with stereotactic frame-assisted surgery, ROSA-assisted operation seems to be associated with shorter operation duration, earlier extubation time, and lower incidence of postoperative rebleeding, intracranial infection and 30-day mortality rate for HICH patients, which is thus worthy of clinical promotion. Key words: Intracranial hemorrhage, hypertensive; Neurosurgical procedures; Treatment outcome; Robotized stereotactic assistant; Stereotactic frame