To compare the safety and efficacy of neuroendoscopy and burr hole drainage in the treatment of chronic subdural hematoma by meta-analysis.

From March 1990 to February 2023, the three databases of Cqvip, CNKI and Wanfang were searched to find out the RCT studies and to compare the neuroendoscopy treatment of chronic subdural hematoma with trephorization alone. Using three databases (Cqvip, CNKI and Wanfang), the RCT studies comparing with neuroendoscopy and burr hole drainage in the treatment of chronic subdural hematoma from March 1990 to February 2023 were obtained. RevMan5.3 software was used for meta-analysis of the selected literatures that met the inclusion criteria.

A total of 599 patients were enrolled in 6 studies. Meta-analysis suggested that the neuroendoscopy group had obvious advantages over the control group in terms of length of stay, postoperative recurrence and postoperative complications, and the operation time was longer than that of the control group. There were statistically significant differences between the two treatment modalities (P<0.01). The combined value of OR (95% CI) was 14.93 (13.35~16.51), -1.69 (-1.85~-1.54), 0.19 (0.09~0.37), and 0.19 (0.10~0.38), respectively and the differences were statistically significant (P<0.05).

For chronic subdural hematoma, compared with simple burr hole drainage, neuroendoscopy has a slightly longer operation time, a shorter hospital stay, and significantly fewer postoperative recurrence and complications. Therefore, the safety and effectiveness of neuroendoscopy are accurate, worthy of promotion and application.