Three-Dimensional Printing Guide Plate-Guided Surgery Versus Computed Tomography-Guided Surgery for Intracerebral Hemorrhage: A Systematic Review and Meta-Analysis.

Abstract

Objective: Computed tomography-guided intracerebral hematoma puncture is associated with issues such as significant localization errors and the need for multiple punctures. This study conducted a meta-analysis to systematically evaluate the differences in safety and accuracy between 3D printing guide plate localization and CT localization techniques in intracerebral hematoma evacuation procedures, providing evidence for primary care hospitals to adopt precise puncture techniques.

Methods: A systematic search was conducted across 12 databases, including PubMed, the Cochrane Library, Web of Science, Embase, Scopus, and the China National Knowledge Infrastructure (CNKI). The quality of studies was assessed using the Newcastle-Ottawa Scale or the Methodological Index for Non-Randomized Studies, depending on the study design. Data analysis was performed using statistical software.

Results: A comprehensive analysis of 28 clinical studies involving 2319 patients revealed that 3D printing guide plate localization technology offers significant advantages over CT localization in intracerebral hematoma puncture treatment, including higher puncture accuracy (P ˂ 0.05), better postoperative neurological function recovery (postoperative Glasgow Coma Scale scores, P < 0.05), superior clinical efficacy (P ˂ 0.05), and higher single-puncture success rates (P ˂ 0.05). Although there were no significant differences between the two groups in terms of long-term outcomes (Glasgow Outcome Scale, P = 0.81), hematoma evacuation rate (P = 0.06), and complication incidence (P = 0.92), 3D printing technology significantly reduced mortality (P ˂ 0.05) and hospitalization costs (P ˂ 0.05).

Conclusions: Current evidence suggests that 3D printing plate localization technique is a safer, more precise, and cost-effective approach for intracerebral hematoma puncture, especially applicable in primary care hospitals.