Comparison of open and endoscopic carpal tunnel surgery regarding clinical outcomes, complication and return to daily life: A prospective comparative study

Abstract

Objective:This study aimed to compare the clinical results and complications as well as patient satisfaction in patients with carpal tunnel syndrome operated with open carpal tunnel release (OCTR) or endoscopic carpal tunnel release (ECTR) techniques.Methods:This study conducted in Istanbul Training and Research Hospital between August 2016 and January 2018. A total of 54 patients were operated with the ECTR technique and 50 patients were operated with the OCTR technique after failing nonsurgical treatment. Patients functional scores are assessed with the carpal tunnel syndrome-functional status score (CTS-FSS) and carpal tunnel syndrome-symptom severity score (CTS-SSS). Operation time, incision length and complications of the two techniques were noted and compared.Results:The age, sex distribution, distribution of sides, and complaint period were not significant (p > 0.05) between the groups. The preoperative or postoperative CTS-SSS and CTS-FSS values did not differ significantly (p > 0.05). Incision length, time to return to work and return to daily life in the OCTR group was significantly higher than the ECTR group (p < 0.05).Conclusion:ECTR has similar results in terms of symptom relief, severity, functional status, pillar pain and complication rates compared to OCTR. However, it has the advantages of early return to daily life, early return to work and less incision length.

Comparison of clinical outcomes between open and modified endoscopic release for carpal tunnel syndrome

“…In addition, the incision may be appropriately expanded to increase the scope of the naked eye, the median nerve is well exposed and the risk of median nerve injury is further reduced by using soft glue tube and other protective measures. This method achieved a similar curative effect to that reported by others (28,38).…”

Análisis de los determinantes que influyen en el retorno al trabajo tras intervención quirúrgica por síndrome del túnel carpiano

“…Finalmente, Gürpinar et al 3 en 2019 publicaron los resultados obtenidos a partir de un estudio de cohortes prospectivo realizado en Turquía con una muestra de 104 pacientes. De todos ellos, 54 pacientes fueron sometidos a una cirugía endoscópica de liberación del túnel del carpo y 50 a una cirugía abierta.…”

“…Por su parte Degeorge et al 12 , añade que la endoscopia bilateral simultánea permite un rápido retorno al trabajo y es más costoefectiva que la anterior, aunque recomienda reservarla para personas dependientes con clínica bilateral severa. Una comparativa entre intervención endoscópica y abierta formulada por Gürpinar et al 3 muestra una media de 9 días más en su tiempo de retorno al trabajo que en los intervenidos endoscópicamente. Ante un resultado de mayor costoefectividad de la cirugía bilateral simultánea en el estudio previamente mencionado, sería interesante adquirir más datos sobre este resultado obtenido para intentar homogeneizar el tipo de cirugía empleada y poder optar por la mejor opción terapéutica en beneficio del paciente y de la empresa o entidad responsable.…”

“…Existen varios tipos de cirugías, siendo en los últimos años las más utilizadas la mínimamente invasiva y la endoscópica, ya que estas técnicas menos invasivas disminuyen el dolor postoperatorio y los síntomas iatrogénicos 3,16,17 . Se cree que el método endoscópico reduce también el dolor postoperatorio, la cicatriz y además tiene una mayor recuperación de la función y vuelta al trabajo.…”

Median nerve transection following carpal tunnel release with an unusual surgical approach: A case study

“…Unfortunately, little attention has been paid to iatrogenic complications, especially median nerve injury, following mini-open carpal tunnel surgery. Nerve lacerations reported in the literature mainly document the palmar cutaneous branch of the median nerve, which is considered, at least by Louis et al [5], to be the most frequent complication of OCTR [6][7][8][9][10][11][12]. The most disquieting complications for any surgeon are those in which an unexpected and unfavorable outcome requires additional intervention to repair the damage.…”