Efficacy of minimally invasive surgery versus conventional procedures for thalamic stroke hemorrhage: systematic review and meta-analysis

Stroke is the second leading cause of death globally. Intracranial hemorrhage is the most destructive type, with the thalamus being the location that has the worst prognosis. A meta-analysis of minimally invasive surgery in intracranial hemorrhage patients has been carried out previously and resulted in an improved prognosis. However, the efficacy and safety of minimally invasive surgery procedures remain subjects of debate. A comprehensive search was conducted in major databases such as PubMed, Scopus, Web of Science, Sage, Taylor and Francis, and Preprints in August 2024. From the search results, 2798 articles were obtained and then selected into ten articles. A risk ratio analysis was performed to compare the prognosis of minimally invasive surgery with conventional procedures. Risk ratios and 95% confidence intervals for minimally invasive surgery compared with conventional procedures in clinical trials and observational studies were 0.68 [0.55–0.84] and 0.57 [0.46–0.71], respectively. This meta-analysis also demonstrated that there was a significant reduction in the risk of death and the length of hospital stay in minimally invasive surgery patients. Nevertheless, there was no difference in the risk of rebleeding when compared with conventional procedures in patients with hemorrhagic stroke localized to the thalamus.