Endoscopic Versus Open Carpal Tunnel Release: A Systematic Review of Outcomes and Complications.

Autor:	Rajapandian R; Trauma and Orthopedics, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA., Moti Wala S; Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA., Aledani EM; Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA., Samuel EA; Physical Medicine and Rehabilitation, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA., Ahmad K; Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA., Manongi NJ; Health Sciences and Public Health, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA., Rauf Butt S; Research, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Jul 20; Vol. 16 (7), pp. e64991. Date of Electronic Publication: 2024 Jul 20 (Print Publication: 2024).
DOI:	10.7759/cureus.64991
Abstrakt:	Carpal tunnel syndrome (CTS) is a condition that causes discomfort due to the compression of the median nerve in the wrist. Carpal tunnel release (CTR) is a surgical procedure that can help alleviate the symptoms of CTS. Two methods are commonly used for CTR: endoscopic carpal tunnel release (ECTR) and open carpal tunnel release (OCTR). The choice of method can impact surgical outcomes and potential complications. This review aims to compare the outcomes of both methods for individuals diagnosed with CTS. This systematic review analyzes the outcomes and potential complications of ECTR and OCTR for CTS. The study encompassed a comprehensive analysis of randomized controlled trials (RCTs) and meta-analyses comparing both methods. We searched for studies released between January 2012 and October 2023 on PubMed, Science Direct, and Google Scholar. The researchers assessed the quality of studies using the Cochrane risk of bias tool and the AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews) tool. The study's scope included a range of outcomes and complications, such as symptom relief, functional recovery, grip strength, return to work, patient satisfaction, scar sensitivity, pillar pain, wound complications, nerve-related issues, morphological changes, and recurrence. The review analyzed 11 studies, including seven RCTs and four meta-analyses. These studies evaluated 4367 ECTR and 4107 cases of OCTR. The patients' ages ranged from 46 to 58, and the follow-up periods ranged from three to 24 months. The findings reveal that ECTR has comparable or better outcomes than OCTR, particularly in postoperative discomfort, functional recovery, grip strength, resumption of work, and patient satisfaction. Additionally, ECTR has lower levels of scar sensitivity, pillar pain, and wound-related complications than OCTR. However, ECTR carries a higher risk of reversible nerve injury. There were no substantial differences between the two techniques regarding other potential complications. Both ECTR and OCTR are safe and effective interventions for CTS. ECTR has benefits like faster recovery and improved cosmetic outcomes but requires higher technical proficiency and carries the risk of nerve injury. The choice of technique should consider patient preference, cost-effectiveness, and surgeon expertise. Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. (Copyright © 2024, Rajapandian et al.)
Databáze:	MEDLINE
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