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Efficacy and safety of The Robotic Stereotactic Assistance for intracerebral hemorrhage; A systematic review and meta-analysis

M. Elfakhrany, N. Al-dardery, Sadil Mohammad Bani Khaled, Mohamed El-Samahy, Shahd Alqato, Suhel.F.Batarseh, A. Abdelsattar, M. Abouzid

Neurosurgical review, 2025

968 participants · 2 citations

Abstract

Intracerebral hemorrhage (ICH) is a critical medical condition associated with a high mortality rate. Surgical evacuation of extensive hemorrhage can improve survival and functional outcomes, but deep brain location poses a challenge. Our study seeks to provide robust evidence highlighting the efficacy, safety, and contribution of Robotic Stereotactic Assistance (ROSA) in advancing neurosurgical practices in the evacuation of ICH compared to conventional treatment methods. We searched for relevant papers comparing ROSA with conventional treatments until October 2024, using four electronic databases: PubMed, Scopus, the Cochrane Library, and Web of Science. The analysis was done using R Software. Continuous data was pooled as mean difference (MD), and dichotomous data was pooled as odds ratio (OR) in a random effect model with a relative 95% CI. A sub-group analysis was conducted according to the type of conventional therapy and the site of the hemorrhage. Eleven studies, comprising 968 patients (478 in the ROSA group and 490 in the control group “non-ROSA”), were included in the systematic review and meta-analysis. The analysis of primary outcomes revealed significantly higher postoperative Glasgow Coma Scale (GCS) scores, MD of 1.80 (95% CI: 0.68 to 2.92; p < 0.01), and lower rebleeding rates, OR of 0.26 (95% CI: 0.10 to 0.66; p < 0.01). However, no significant difference in mortality was found between the two groups, with an OR of 0.38 (95% CI: 0.11 to 1.38; p = 0.14).…

How strong is the evidence?

Evidence Hub reads this as a meta-analysis. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 968 participants or records.

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