{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T01:13:01Z","timestamp":1777770781764,"version":"3.51.4"},"reference-count":57,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100007914","name":"University of Texas Southwestern Medical Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007914","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Spontaneous supratentorial intracerebral hemorrhage (ICH) is a critical condition with high morbidity and mortality rates warranting urgent surgical evacuation. This systematic review and meta\u2010analysis compare the safety and efficacy of neuro\u2010endoscopy (NE) versus traditional craniotomy (CR) for managing ICH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From inception until July 2024, a comprehensive literature search was undertaken on PubMed, Cochrane Central, ScienceDirect, and Clinicaltrials.gov. Risk ratios (RR) and weighted mean differences (WMD) were pooled for categorical and continuous outcomes under the random effects model in Review Manager software. 5.4.1. Leave\u2010one\u2010out sensitivity analysis, Egger's regression, GRADE assessment, and meta\u2010regression were performed to evaluate the heterogeneity, publication bias, certainty of evidence, and effect size variability, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Our meta\u2010analysis included eight clinical trials and 20 cohort studies with 9,437 patients. NE outperformed CR in terms of favorable neurological outcomes (RR = 1.59, 95% CI: [1.30,1.94]; p\u00a0&lt;\u00a00.00001; I\n                      <jats:sup>2<\/jats:sup>\n                      = 90%), mortality (RR = 0.62, 95% CI:[0.48,0.81]; p &lt; 0.0004; I\n                      <jats:sup>2<\/jats:sup>\n                      = 51%), hematoma evacuation rate (WMD = 7.17, 95% CI: [4.68,9.65]%; p &lt; 0.00001; I\n                      <jats:sup>2<\/jats:sup>\n                      = 94%) operating time (WMD = \u2010102.08 min, 95 CI: [\u2010120.29,\u201083.87]; p &lt; 0.00001; I\n                      <jats:sup>2<\/jats:sup>\n                      = 98%), blood loss (WMD = \u2010255.51 mL, 95% CI: [\u2010383.61,\u2010127.41]; p &lt; 0.0001; I\n                      <jats:sup>2<\/jats:sup>\n                      = 100%), length of hospital stay (WMD = \u20103.34 days, 95% CI: [\u20105.05,\u20101.64] days; p\u00a0&lt;\u00a00.0001; I\n                      <jats:sup>2<\/jats:sup>\n                      = 62%), ICU stay (WMD = \u20102.85, 95% CI: [\u20105.13,\u20100.57] days; p &lt; 0.01; I\n                      <jats:sup>2<\/jats:sup>\n                      = 96%), meningitis (RR = 0.58, 95% CI: [0.36,0.95]; p &lt; 0.03; I\n                      <jats:sup>2<\/jats:sup>\n                      = 10 %), infections (RR = 0.49, 95% CI: [0.35,0.67]; p\u00a0&lt;\u00a00.0001; I\n                      <jats:sup>2<\/jats:sup>\n                      = 51%), residual hematoma volume (MD = \u20102.22; 95% CI: [\u20103.37,\u20101.07]; p &lt; 0.0002; I\n                      <jats:sup>2<\/jats:sup>\n                      = 90%) and overall complications (RR = 0.52, 95% CI: [0.40\u20100.67]; p &lt; 0.00001; I\n                      <jats:sup>2<\/jats:sup>\n                      = 70%). In addition, re\u2010bleeding was found to be comparable between the CR and NE groups (p = 0.08).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>NE treatment for spontaneous intracerebral hemorrhage (ICH) is associated with favorable neurological outcomes, decreased mortality, shorter operating time, reduced blood loss and residual volume, shorter length of hospital and intensive care unit (ICU) stay, and fewer infections, meningitis, and overall complications; however, the re\u2010bleeding rate was found to be comparable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.70581","type":"journal-article","created":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T15:34:27Z","timestamp":1756740867000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy and Safety of Neuroendoscopy versus Craniotomy for Spontaneous Supratentorial Intracerebral Hemorrhage: An Updated Meta\u2010Analysis of Randomized and Non\u2010Randomized Studies"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4521-3256","authenticated-orcid":false,"given":"Muhammad Hassan","family":"Waseem","sequence":"first","affiliation":[{"name":"Allama Iqbal Medical College  Lahore Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8990-7738","authenticated-orcid":false,"given":"Zain ul","family":"Abideen","sequence":"additional","affiliation":[{"name":"King Edward Medical University  Lahore Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8375-1871","authenticated-orcid":false,"given":"Nohela","family":"Rehman","sequence":"additional","affiliation":[{"name":"Dow University of Health Sciences  Karachi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3250-2601","authenticated-orcid":false,"given":"Muhammad Haris","family":"Khan","sequence":"additional","affiliation":[{"name":"Saidu Medical College  Swat Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6936-9517","authenticated-orcid":false,"given":"Muhammad Fawad","family":"Tahir","sequence":"additional","affiliation":[{"name":"H.B.S Medical and Dental College  Islamabad Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0794-7013","authenticated-orcid":false,"given":"Hafsa Arshad Azam","family":"Raja","sequence":"additional","affiliation":[{"name":"Rawalpindi Medical University  Rawalpindi Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2508-4370","authenticated-orcid":false,"given":"Ameer Haider","family":"Cheema","sequence":"additional","affiliation":[{"name":"UT Southwestern Medical Center  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-1931-4337","authenticated-orcid":false,"given":"Sania","family":"Aimen","sequence":"additional","affiliation":[{"name":"Quetta Institute of Medical Sciences  Quetta Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2627-685X","authenticated-orcid":false,"given":"Javed","family":"Iqbal","sequence":"additional","affiliation":[{"name":"Hamad Medical Corporation  Doha Qatar"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,9,1]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.5853\/JOS.2016.00864"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.3171\/JNS.1989.70.4.0530"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000008435"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.5847\/WJEM.J.ISSN.1920\u20108642.2014.03.008"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.SURNEU.2005.09.032"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/S41016\u2010022\u201000304\u20101\/TABLES\/3"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.21037\/ATM\u201021\u20101612"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.WNEU.2018.02.056"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.5137\/1019\u20105149.JTN.12669\u201014.0"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.WNEU.2018.10.192"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.25259\/SNI_872_2020"},{"key":"e_1_2_13_13_1","unstructured":"Ga W.2013.The Newcastle\u2010Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta\u2010analyses. 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