Outcomes Following Endoscopic versus Open Carpal Tunnel Release-A Matched Study

被引:6
作者
Khalid, Syed I. [1 ]
Deysher, Daniel [1 ]
Thomson, Kyle [2 ]
Khilwani, Harsh [1 ]
Mirpuri, Pranav [2 ]
Maynard, Marquis [3 ]
Adogwa, Owoicho [4 ]
Mehta, Ankit I. [1 ]
机构
[1] Univ Illinois, Dept Neurosurg, Chicago, IL 60607 USA
[2] Rosalind Franklin Sch Med & Sci, Chicago Med Sch, N Chicago, IL USA
[3] Case Western Reserve Sch Med, Cleveland, OH USA
[4] Univ Cincinnati, Dept Neurosurg, Cincinnati, OH USA
关键词
Carpal tunnel release; Carpal tunnel syndrome; Endoscopic; Neuropathy; Outcomes; COST-EFFECTIVENESS; COMPLICATIONS; SURGERY;
D O I
10.1016/j.wneu.2022.11.115
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
-OBJECTIVE: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy in the world. Surgical treatment can be performed in an open or endoscopic fashion. To date, similar rates of complications for both approaches have been described. We sought to compare the results of endoscopic carpal tunnel release (ECTR) with open carpal tunnel release (OCTR) in patients with CTS. -METHODS: Patients with a diagnosis of CTS undergoing open or endoscopic surgical management were identified between January 2010 and October 2020. The primary outcome of the study was nerve injury within 30 days of the procedure. Secondary outcomes included readmission, wound-related complications, hematoma, seroma forma-tion, and cost.-RESULTS: A total of 735,631 patients were identified as -ndergoing CTR. Following a 1:1 match procedure, 292,626 patient records were analyzed. Patients undergoing OCTR versus ECTR had an increased odds of readmission at 30 days (odds ratio [OR] 1.89, 95% confidence interval [CI] 1.73-2.06), developing an infection (OR 1.59, 95% CI 1.41-1.80), and experiencing wound complications (OR 1.97, 95% CI 1.74-2.23). No significant difference in odds of devel-oping a seroma (OR 1.17, 95% CI 0.83-1.65), hematoma (OR 1.15, 95% CI 0.95-1.39), or nerve injury (OR 1.18, 95% CI 0.98-1.43) was noted. The reimbursement cost of ECTR was significantly greater than OCTR ($310.60 +/- $1639.57 vs. $237.69 +/- $1488.93, P < 0.001). -CONCLUSIONS: In the largest study to date on the sur-gical management of CTR, OCTR was seen to be associated with an increased odds of readmission, infection, and wound complications, but reduced costs for the procedure alone.
引用
收藏
页码:E162 / E171
页数:10
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