Results of Endoscopic Carpal Tunnel Release Relative to Surgeon Experience With the Agee Technique

Beck, John D.; Deegan, John H.; Rhoades, Diana; Klena, Joel C.

doi:10.1016/j.jhsa.2010.10.017

Cited by 52 publications

(25 citation statements)

References 28 publications

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“… 7 8 13–19 In our OSS clinic, primary open surgery was conducted in cases of severe neurological impairment or reoperations, which could account for the less good symptom relief observed in our study with the planned open procedure. As in the study by Beck et al , 18 we did not find a difference in symptom relief between the converted and endoscopic procedure.…”

Section: Discussionsupporting

confidence: 78%

Is one-stop surgery for carpal tunnel syndrome safe? A retrospective long-term follow-up study in a neurosurgical unit in Copenhagen

Jørgensen

Piil²,

Bashir

et al. 2017

BMJ Open

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ObjectivesThe aim of this study was to evaluate one-stop surgery (OSS) for carpal tunnel syndrome (CTS) regarding symptom relief and patient satisfaction. OSS in our setting means only one visit to the hospital for surgery and no hospital appointments for preassessment or follow-up. We hypothesised that relief of symptoms with OSS is comparable with that in non-OSS patients reported in the literature.DesignThis is a long-term retrospective follow-up study (56.5 months) of 1003 patients referred for CTS and discharged with or without surgery from an OSS clinic. Of the original cohort, 671 patients completed the long-term follow-up telephone interview.ResultsTwo-thirds of the patients were free of even minor symptoms following surgery. The symptom relief and patient satisfaction in this study were comparable with results in non-OSS patients reported in the literature.ConclusionThe implementation of a clinical pathway and OSS for the management of CTS was safe with good long-term symptom relief and high patient satisfaction.

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Section: Discussionsupporting

confidence: 78%

Is one-stop surgery for carpal tunnel syndrome safe? A retrospective long-term follow-up study in a neurosurgical unit in Copenhagen

Jørgensen

Piil²,

Bashir

et al. 2017

BMJ Open

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“…Compared to endoscopic methods, our technology does not require expensive equipment. [29,31,32] Furthermore, a number of RCTs have been conducted to date without showing clear advantages of any procedure, and neither of these techniques is clearly favored at present. Thus, the purpose of our meta-analysis was to determine whether limited compared with standard relief provides better symptom relief, short- and long-term strength; different risks of complications such as nerve injury, pain, and reoperation; allows an earlier return to activities; and takes less operative time.…”

Section: Discussionmentioning

confidence: 99%

The comparison of limited-incision versus standard-incision in treatment of carpal tunnel syndrome

Kong

Kou³

et al. 2019

Medicine

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Background: Carpal tunnel syndrome is a common compressive neuropathy of the median nerve. Compared with standard release, the efficacy, safety, and postoperative complications of limited carpal tunnel release remain controversial. The purpose of this study was to compare the effects of the 2 treatments. Methods: The English-language literature was searched using MEDLINE, Web of Science, and Embase. Randomized controlled trials that compared standard and limited incision for carpal tunnel release were included in the meta-analysis. Strength, interval to return to activities, the rate of adverse events, effectiveness, and operative time were compared. Results: Thirteen randomized controlled trials (RCTs) containing 1020 patients were included. Limited incision treated patients showed better early recovery of grip strength (mean difference [MD], 4.25 [0.86–7.65]; P = .01) and pinch strength (MD, 1.37 [0.24–2.51]; P = .02) but no advantage after more than 6 months. Patients treated with limited incision showed an earlier return to activities (MD,−8.80 [−9.21 to −8.39]; P < .01) and reduced operative time (standardized mean difference [SMD], −1.68 [−3.24 to−0.12]; P = .04). The rate of adverse event was significantly higher in standard group compared with that in limited group (risk ratio [RR] 0.61, 95% CI 0.38–0.96, P = .03). Conclusions: Limited incision release allows us to return to activities early, reduces operative time, decreases rate of adverse events, and improves strength during the early postoperative period. Results at 6 months or longer are similar according to current data. However, the results of this meta-analysis should be interpreted with caution due to heterogeneity amongst the included studies.

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“…It has been suggested that ECTR has a relatively high learning curve [ 65 , 66 ]. Although ECTR is considered a safe procedure, meticulous training is mandatory before starting clinical practice.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic and Open Release Similarly Safe for the Treatment of Carpal Tunnel Syndrome. A Systematic Review and Meta-Analysis

et al. 2015

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BackgroundThe Endoscopic Release of Carpal Tunnel Syndrome (ECTR) is a minimal invasive approach for the treatment of Carpal Tunnel Syndrome. There is scepticism regarding the safety of this technique, based on the assumption that this is a rather “blind” procedure and on the high number of severe complications that have been reported in the literature.PurposeTo evaluate whether there is evidence supporting a higher risk after ECTR in comparison to the conventional open release.MethodsWe searched MEDLINE (January 1966 to November 2013), EMBASE (January 1980 to November 2013), the Cochrane Neuromuscular Disease Group Specialized Register (November 2013) and CENTRAL (2013, issue 11 in The Cochrane Library). We hand-searched reference lists of included studies. We included all randomized or quasi-randomized controlled trials (e.g. study using alternation, date of birth, or case record number) that compare any ECTR with any OCTR technique. Safety was assessed by the incidence of major, minor and total number of complications, recurrences, and re-operations.The total time needed before return to work or to return to daily activities was also assessed. We synthesized data using a random-effects meta-analysis in STATA. We conducted a sensitivity analysis for rare events using binomial likelihood. We judged the conclusiveness of meta-analysis calculating the conditional power of meta-analysis.ConclusionsECTR is associated with less time off work or with daily activities. The assessment of major complications, reoperations and recurrence of symptoms does not favor either of the interventions. There is an uncertain advantage of ECTR with respect to total minor complications (more transient paresthesia but fewer skin-related complications). Future studies are unlikely to alter these findings because of the rarity of the outcome. The effect of a learning curve might be responsible for reduced recurrences and reoperations with ECTR in studies that are more recent, although formal statistical analysis failed to provide evidence for such an association. Level of evidence: I.

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Results of Endoscopic Carpal Tunnel Release Relative to Surgeon Experience With the Agee Technique

Cited by 52 publications

References 28 publications

Is one-stop surgery for carpal tunnel syndrome safe? A retrospective long-term follow-up study in a neurosurgical unit in Copenhagen

Is one-stop surgery for carpal tunnel syndrome safe? A retrospective long-term follow-up study in a neurosurgical unit in Copenhagen

The comparison of limited-incision versus standard-incision in treatment of carpal tunnel syndrome

Endoscopic and Open Release Similarly Safe for the Treatment of Carpal Tunnel Syndrome. A Systematic Review and Meta-Analysis

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