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The keyhole approach in aneurysm surgery. Comparation between keyhole approach and standard approach

Objective: The purpose of this study is to compare the results of minimally invasive keyhole craniotomy and standard larger craniotomies in surgical treatment of patients with intracranial aneurysms. Patients and Methods: Among 562 patients with intracranial aneurysms in a 7-year period, 427 patient was operated through small keyhole craniotomy, using the eyebrow keyhole approach in particular. During the same period the remaining135 patients were operated using standard larger approaches. Both groups were similarly mached according to the Hunt-Hess scale, and Glasgow outcome scale. Results: Comparison of surgical outcomes for both groups gave a similar result. We have found excellent and very good outcome (GOS 5 and 4) in 351 (82, 21%) patients from keyhole craniotomy group, and in standard craniotomy group the same outcome was found in 109 patients (80, 74%). The mortality rate was 0, 93% for keyhole group of patients and 2, 22% for standard craniotomy group. Conclusions: Our study has shown no difference in outcome for both groups. Results are especially good for keyhole group of patients. The advantages of the keyhole concept should be considered as a good alternative to endovascular treatment in some patients.

keyhole; minimally invasive neurosurgery

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