{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T01:41:38Z","timestamp":1792201298716,"version":"4.4.0"},"reference-count":24,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:00:00Z","timestamp":1792108800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"abstract":"ABSTRACT<\/jats:title>\n \n Objective<\/jats:title>\n Chronic subdural hematoma (CSDH) is prevalent in the elderly. Its septated variant poses a significant surgical challenge, as conventional burr\u2010hole drainage often yields suboptimal results due to incomplete evacuation. Neuroendoscopy has emerged as a potential solution, but robust comparative evidence is lacking.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n In this single\u2010center retrospective cohort study, we enrolled 100 patients with radiologically confirmed septated CSDH. Fifty\u2010two underwent neuroendoscopic\u2010assisted evacuation (Endoscopic Group), and 48 underwent conventional burr\u2010hole drainage (Burr\u2010Hole Group). We compared intraoperative metrics (operative time, blood loss, irrigation volume, hematoma evacuation rate), drainage duration, recurrence, and neurological\/functional outcomes (mRS, NIHSS, ADL, GOS) at 6\u2009months.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The Endoscopic Group demonstrated a significantly higher hematoma evacuation rate (89.96% vs. 81.64%,\n p<\/jats:italic>\n \u2009<\u20090.001) with substantially less irrigation fluid (587 vs. 1538\u2009mL,\n p<\/jats:italic>\n \u2009<\u20090.001), despite a longer operative time (68.34 vs. 47.52\u2009min,\n p<\/jats:italic>\n \u2009<\u20090.001). The endoscopic approach also led to shorter drainage retention (median 1.0 vs. 2.0\u2009days,\n p<\/jats:italic>\n \u2009<\u20090.001) and a significantly reduced recurrence rate (0% vs. 12.5%,\n p<\/jats:italic>\n \u2009=\u20090.010). At 6\u2009months, the Endoscopic Group showed superior outcomes, evidenced by more favorable mRS distributions (\n p<\/jats:italic>\n \u2009=\u20090.004), lower NIHSS scores (7.42 vs. 8.26,\n p<\/jats:italic>\n \u2009=\u20090.006), higher ADL scores (92.78 vs. 84.45,\n p<\/jats:italic>\n \u2009<\u20090.001), and better GOS ratings (\n p<\/jats:italic>\n \u2009=\u20090.014). Overall complication rates were comparable (5.8% vs. 14.6%,\n p<\/jats:italic>\n \u2009=\u20090.134).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Neuroendoscopic\u2010assisted burr\u2010hole evacuation is a highly effective strategy with a favorable safety profile for septated CSDH. By ensuring more complete evacuation via direct septal disruption, this technique facilitates faster recovery, significantly lowers recurrence, and improves long\u2010term functional outcomes, justifying the longer operative time.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/ans.71008","type":"journal-article","created":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T01:01:11Z","timestamp":1792198871000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Neuroendoscopic\u2010Assisted vs. Conventional Burr\u2010Hole Drainage for Septated Chronic Subdural Hematoma: A Comparative Cohort Study on Efficacy and Long\u2010Term Functional Outcomes"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-4031-6788","authenticated-orcid":false,"given":"Wentao","family":"Lai","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Ganzhou Hospital\u2010Nanfang Hospital, Southern Medical University Ganzhou China"},{"name":"Department of Neurosurgery Ganzhou People's Hospital Ganzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanlin","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Ganzhou Hospital\u2010Nanfang Hospital, Southern Medical University Ganzhou China"},{"name":"Department of Neurosurgery Ganzhou People's Hospital Ganzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuanyun","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Surgery II Yudu County Second People's Hospital Ganzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Hematology Ganzhou Hospital\u2010Nanfang Hospital, Southern Medical University Ganzhou China"},{"name":"Department of Hematology Ganzhou People's Hospital Ganzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1452-668X","authenticated-orcid":false,"given":"Xinyun","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Ganzhou Hospital\u2010Nanfang Hospital, Southern Medical University Ganzhou China"},{"name":"Department of Neurosurgery Ganzhou People's Hospital Ganzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,16]]},"reference":[{"issue":"1","key":"e_1_2_8_2_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2176\/jns-nmc.2022-0207","article-title":"Chronic Subdural Hematoma\u2010Evolution of Etiology and Surgical Treatment","volume":"63","author":"Uno M.","year":"2023","journal-title":"Neurologia Medico\u2010Chirurgica"},{"issue":"9","key":"e_1_2_8_3_1","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1056\/NEJMoa2409845","article-title":"Embolization of the Middle Meningeal Artery for Chronic Subdural Hematoma","volume":"392","author":"Fiorella D.","year":"2025","journal-title":"New England Journal of Medicine"},{"key":"e_1_2_8_4_1","doi-asserted-by":"crossref","first-page":"732","DOI":"10.3171\/2016.8.JNS16134","article-title":"The Management and Outcome for Patients With Chronic Subdural Hematoma: A Prospective, Multicenter, Observational Cohort Study in the United Kingdom","volume":"127","author":"Brennan P. M.","year":"2017","journal-title":"Journal of Neurosurgery"},{"issue":"10446","key":"e_1_2_8_5_1","doi-asserted-by":"crossref","first-page":"2798","DOI":"10.1016\/S0140-6736(24)00686-X","article-title":"Burr\u2010Hole Drainage With or Without Irrigation for Chronic Subdural Haematoma (FINISH): A Finnish, Nationwide, Parallel\u2010Group, Multicentre, Randomised, Controlled, Non\u2010Inferiority Trial","volume":"403","author":"Raj R.","year":"2024","journal-title":"Lancet"},{"key":"e_1_2_8_6_1","doi-asserted-by":"crossref","first-page":"e408","DOI":"10.1016\/j.wneu.2021.03.029","article-title":"Fibrinolytic\u2010Facilitated Chronic Subdural Hematoma Drainage\u2010A Systematic Review","volume":"150","author":"Mang O Y.","year":"2021","journal-title":"World Neurosurgery"},{"key":"e_1_2_8_7_1","doi-asserted-by":"crossref","first-page":"e427","DOI":"10.1016\/j.wneu.2023.10.076","article-title":"Neuroendoscopic Technique for Septated Chronic Subdural Hematoma: A Retrospective Study","volume":"181","author":"Li B.","year":"2024","journal-title":"World Neurosurgery"},{"issue":"1","key":"e_1_2_8_8_1","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1186\/s12974-017-0881-y","article-title":"Pathophysiology of Chronic Subdural Haematoma: Inflammation, Angiogenesis and Implications for Pharmacotherapy","volume":"14","author":"Edlmann E.","year":"2017","journal-title":"Journal of Neuroinflammation"},{"key":"e_1_2_8_9_1","doi-asserted-by":"crossref","first-page":"765109","DOI":"10.3389\/fneur.2021.765109","article-title":"Efficacy of Neuroendoscopic Treatment for Septated Chronic Subdural Hematoma","volume":"12","author":"Deng J.","year":"2021","journal-title":"Frontiers in Neurology"},{"issue":"2","key":"e_1_2_8_10_1","first-page":"251","article-title":"Analysis of Preoperative Imaging Factors and Development of a Nomogram Model for Predicting Recurrence in Patients With Septated Chronic Subdural Hematoma","volume":"35","author":"Cao X.","year":"2025","journal-title":"Turkish Neurosurgery"},{"issue":"3","key":"e_1_2_8_11_1","doi-asserted-by":"crossref","first-page":"805","DOI":"10.3390\/jcm13030805","article-title":"Retrospective Analysis of Risk Factors for Recurrence of Chronic Subdural Haematoma After Surgery","volume":"13","author":"Zawy Alsofy S.","year":"2024","journal-title":"Journal of Clinical Medicine"},{"key":"e_1_2_8_12_1","doi-asserted-by":"crossref","first-page":"e452","DOI":"10.1016\/j.wneu.2024.05.137","article-title":"Endoscopic Management of Chronic Subdural Hematoma Using a Novel Brain Retractor","volume":"188","author":"Sharma M.","year":"2024","journal-title":"World Neurosurgery"},{"key":"e_1_2_8_13_1","doi-asserted-by":"crossref","first-page":"789118","DOI":"10.3389\/fsurg.2022.789118","article-title":"Rigid Neuroendoscopy Assisted Hematoma Resection Reduces the Recurrence Rate of Chronic Subdural Hematoma With Mixed Density: A Retrospective Analytic Cohort Study","volume":"9","author":"Fang H.","year":"2022","journal-title":"Frontiers in Surgery"},{"issue":"35","key":"e_1_2_8_14_1","doi-asserted-by":"crossref","first-page":"12920","DOI":"10.12998\/wjcc.v10.i35.12920","article-title":"Efficacy Evaluation of Neuroendoscopy vs Burr Hole Drainage in the Treatment of Chronic Subdural Hematoma: An Observational Study","volume":"10","author":"Wang X. J.","year":"2022","journal-title":"World Journal of Clinical Cases"},{"issue":"6","key":"e_1_2_8_15_1","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1055\/s-0040-1715121","article-title":"Neuroendoscopy\u2010Assisted Evacuation of Chronic Subdural Hematoma With Mixed CT Density Through A Novel Small Bone Flap","volume":"81","author":"Huang C. J.","year":"2020","journal-title":"Journal of Neurological Surgery, Part A: Central European Neurosurgery"},{"key":"e_1_2_8_16_1","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.jocn.2021.07.058","article-title":"Efficacy of Endoscopic Treatment for Chronic Subdural Hematoma Surgery","volume":"92","author":"Amano T.","year":"2021","journal-title":"Journal of Clinical Neuroscience"},{"issue":"2","key":"e_1_2_8_17_1","doi-asserted-by":"crossref","first-page":"113829","DOI":"10.1016\/j.yexcr.2023.113829","article-title":"Rapamycin Promotes Hematoma Resorption and Enhances Endothelial Cell Function by Suppressing the mTOR\/STAT3 Signaling in Chronic Subdural Hematoma","volume":"433","author":"Shen J.","year":"2023","journal-title":"Experimental Cell Research"},{"issue":"1","key":"e_1_2_8_18_1","first-page":"199","article-title":"Two co(II) Coordination Polymers: Magnetic Properties and Application Values Against Chronic Subdural Hematoma","volume":"24","author":"Chen J. S.","year":"2021","journal-title":"Designed Monomers and Polymers"},{"key":"e_1_2_8_19_1","doi-asserted-by":"crossref","first-page":"e753","DOI":"10.1016\/j.wneu.2018.07.039","article-title":"Elevated Serum Fibrinogen Degradation Products on Admission Is a Novel Predictive Factor for Recurrence of Chronic Subdural Hematoma","volume":"118","author":"Hori Y. S.","year":"2018","journal-title":"World Neurosurgery"},{"key":"e_1_2_8_20_1","doi-asserted-by":"crossref","first-page":"578127","DOI":"10.1016\/j.jneuroim.2023.578127","article-title":"Inflammatory Biomarkers Differentiate the Stage of Maturation in Chronic Subdural Hematomas","volume":"381","author":"Svedung Wettervik T.","year":"2023","journal-title":"Journal of Neuroimmunology"},{"issue":"4","key":"e_1_2_8_21_1","doi-asserted-by":"crossref","first-page":"1954","DOI":"10.1177\/15910199241298727","article-title":"Bevacizumab: The Future of Chronic Subdural Hematoma","volume":"32","author":"Verma Y.","year":"2024","journal-title":"Interventional Neuroradiology"},{"key":"e_1_2_8_22_1","doi-asserted-by":"crossref","first-page":"3291","DOI":"10.2147\/DDDT.S256050","article-title":"Atorvastatin Combined With Low\u2010Dose Dexamethasone Treatment Protects Endothelial Function Impaired by Chronic Subdural Hematoma via the Transcription Factor KLF\u20102","volume":"14","author":"Fan Y.","year":"2020","journal-title":"Drug Design, Development and Therapy"},{"issue":"14","key":"e_1_2_8_23_1","first-page":"4983","article-title":"Burr Hole Craniostomy vs. Minicraniotomy of Chronic Subdural Hematoma: A Systematic Review and Meta\u2010Analysis","volume":"26","author":"Huang Y. W.","year":"2022","journal-title":"European Review for Medical and Pharmacological Sciences"},{"issue":"2","key":"e_1_2_8_24_1","doi-asserted-by":"crossref","first-page":"267","DOI":"10.4103\/0028-3886.375434","article-title":"Membrane Tucking Technique Using Ligature Clips With Intermembranous Placement of Oxidized Regenerated Cellulose in Multilayered Chronic Subdural Hematoma: Description of Novel Technique and Our Initial Experience","volume":"71","author":"Singh L.","year":"2023","journal-title":"Neurology India"},{"issue":"5","key":"e_1_2_8_25_1","first-page":"701","article-title":"Neuroendoscopic Technique for Recurrent Chronic Subdural Hematoma With Small Craniotomy","volume":"30","author":"Ichimura S.","year":"2020","journal-title":"Turkish Neurosurgery"}],"container-title":["ANZ Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.71008","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ans.71008","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.71008","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T01:01:15Z","timestamp":1792198875000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ans.71008"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,16]]},"references-count":24,"alternative-id":["10.1111\/ans.71008"],"URL":"https:\/\/doi.org\/10.1111\/ans.71008","archive":["Portico"],"relation":{},"ISSN":["1445-1433","1445-2197"],"issn-type":[{"value":"1445-1433","type":"print"},{"value":"1445-2197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,16]]},"assertion":[{"value":"2025-11-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"ans.71008"}}