Abstract：
Keyhole surgery recently evolved as a minimal invasive surgical approach for treatment of anterior circulation aneurysm. This review was done to evaluate the keyhole approach for anterior circulation aneurysms, their indications, advantages, technical limitations, complications and their avoidance. The literature review was performed with the phrase \"keyhole approach for anterior circulation aneurysm\" as a search term in PubMed central, Medline, Google scholar and Embase data base to identify all the articles published till December 2020. Out of 113 articles searched, 22 were included in this review after screening for eligibility. On analyzing these articles, there was total 2058 aneurysm in 1871 patients. Out of 2058 aneurysm, 988 were ruptured and 547 unruptured. In 5 studies, which include 344 aneurysms in 344 cases, aneurysm ruptured or unruptured status was not specified. The most frequent aneurysm site was anterior communicating artery (n=573). The size of the aneurysm mentioned in most of the study was <15 mm. The rate of complete occlusion was ranged from 93.6-100%. The range of intra operative rupture (IOR) was 0-28.6%. The mean operative time was ranged from 70 min-5.34 hours as reported in 13 studies. Good outcome [Glasgow outcome scale (GOS): 4-5] were seen in 75-100% cases. The frontalis muscle weakness has been reported in 3 studies and ranged from 0-1.99%. Keyhole surgery can be a safe and effective treatment modality for treatment of a selected anterior circulation aneurysm. In the experienced hand it has certain advantages over standard pterional craniotomy.
摘要：
锁孔手术最近发展成为治疗前循环动脉瘤的微创手术方法。这篇综述是为了评估前循环动脉瘤的锁孔入路。他们的适应症，优势,技术限制,并发症及其回避。文献综述以“锁孔入路治疗前循环动脉瘤”作为检索词在PubMed中央，Medline,谷歌学者和Embase数据库来识别到2020年12月发表的所有文章。在搜索的113篇文章中，在筛选合格后，22人被纳入本审查。在分析这些文章时，1871例患者中共有2058例动脉瘤.2058年动脉瘤中,988例破裂，547例未破裂。在5项研究中，其中包括344例动脉瘤，344例，未说明动脉瘤破裂或未破裂状态.最常见的动脉瘤部位是前交通动脉（n=573）。大多数研究中提到的动脉瘤的大小<15mm。完全闭塞率为93.6-100%。术中破裂（IOR）的范围为0-28.6％。根据13项研究的报告，平均手术时间为70分钟-5.34小时。在75-100％的病例中观察到良好的结果[格拉斯哥结果量表（GOS）：4-5]。额肌无力已在3项研究中报道，范围为0-1.99％。锁孔手术可以是治疗选定的前循环动脉瘤的安全有效的治疗方式。在有经验的手中，它比标准的翼状开颅手术有一定的优势。
