3-Dimensional Technology-Assisted Minimally Invasive Surgery for the Treatment of Primary Brainstem Hemorrhage: A Prospective Cohort Study.

Abstract

The objective of this study was to assess the therapeutic efficacy of minimally invasive puncture and drainage (MIPD) facilitated by a 3-dimensional (3D)-printed guide plate in the management of primary brainstem hemorrhage (PBH). This single-center, prospective cohort study enrolled 30 PBH patients who underwent MIPD guided by 3D printing technology and 30 PBH patients who received conservative treatment, serving as the control cohort. The primary endpoint was the proportion of patients achieving modified Rankin Scale scores of 1 and 2 at 30 days postdischarge. Secondary endpoints included hematoma volume at admission and post-treatment, incidence of hospital-acquired pneumonia (HAP) and/or rebleeding, in-hospital mortality rate, and length of hospital stay. The treatment cohort demonstrated a significantly higher proportion of patients with modified Rankin Scale scores of 1 and 2 at 30 days postdischarge compared to the control cohort. Conversely, the treatment cohort exhibited significantly lower postoperative hematoma volumes, National Institutes of Health Stroke Scale scores, HAP incidence, in-hospital mortality, and hospital stay duration than the control cohort. However, no significant difference in rebleeding incidence was observed between the 2 cohorts. MIPD guided by 3D printing technology is more effective than conservative treatment in PBH cases without extensive hemorrhage. This approach can alleviate hematoma pressure earlier, mitigate neurological deficits, reduce HAP incidence, shorten hospital stay, and decrease mortality and disability rates associated with PBH.