IntroductionCarpal tunnel syndrome (CTS) is becoming more widely reported among middle-aged women who frequently use their hands and is the commonest among entrapment neuropathies in the upper limbs. Endoscopic carpal tunnel release (ECTR) was first carried out by Okutsu and his colleagues [1] in 1987. With the development of endoscopic surgical instruments and the trend for minimally invasive surgery, ECTR is becoming widely used as a surgical treatment for CTS. The endoscopic surgery is relatively simple, gives only a small postoperative wound and slight pains, and requires a short period of recovery time, which is thus more helpful for the return to normal life in comparison with open surgery. However, there has been some controversy about the superiority of endoscopic surgery over open surgery in terms of surgical results and potential complications [2 ± 8]. We performed ECTR in patients with CTS and analyzed the surgical results and prognostic factors. AbstractThe purpose of this study is to present the surgical outcome of endoscopic carpal tunnel release (ECTR) for the treatment of carpal tunnel syndrome (CTS). One hundred and thirty-one procedures (36 right hands, 33 left hands and 31 bilateral hands) of single portal ECTR were performed upon 100 patients (age range: 36 ± 77 years, mean age: 52.9 years; 98 women and 2 men) with electrodiagnostically proven CTS for 2.5 years from 2001. Preoperative clinical severity and results of electrodiagnostic studies were compared with surgical outcomes at the minimal 3-month postoperative period. Among 131 cases 125 (95.4 %) with complete or significant relief of symptoms were satisfied and 6 (4.6 %) with partial or no relief of symptoms were dissatisfied. There were 2 cases of major complications (one with ulnar nerve injury and the other with ulnar artery injury) that developed in our early experience of ECTR and 1 case of recurrence. The grade of electrodiagnostic abnormalities was associated with surgical outcome but there was no statistical significance between them. The severity of clinical findings, age at onset and symptom duration were not correlated with surgical outcome. In conclusion, ECTR surgery was effective in relieving the symptoms of CTS with a low complication rate after the learning curve period. Thus, ECTR can be an alternative to the traditional open surgery and can be the first procedure for CTS with several advantages over open methods.

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