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关节镜下与开放性背根神经节切除术:复发率和残留疼痛发生率的前瞻性随机对照比较

Arthroscopic versus open dorsal ganglion excision: a prospective, randomized comparison of rates of recurrence and of residual pain.

作者信息

Kang Lana, Akelman Edward, Weiss Arnold-Peter C

机构信息

Department of Orthopaedic Surgery, Weill Medical College of Cornell University, Hospital for Special Surgery, New York, NY, USA.

出版信息

J Hand Surg Am. 2008 Apr;33(4):471-5. doi: 10.1016/j.jhsa.2008.01.009.

DOI:10.1016/j.jhsa.2008.01.009
PMID:18406949
Abstract

PURPOSE

The purpose of this study was to compare the postoperative rates of ganglion recurrence between arthroscopic and open techniques of dorsal ganglion (DG) excision.

METHODS

A total of 72 patients had either arthroscopic or open excision of a primary, simple DG by 1 of 2 senior hand surgeons. Three prospective postoperative assessments were performed. The first examination was performed at 5 to 7 days, the second at 4 to 8 weeks, and the third assessment was performed at a minimum of 1 year after surgery. Percentages of ganglion recurrence at the second and third assessments were recorded.

RESULTS

Forty-one patients had arthroscopic excision, and 31 patients had open excision. Baseline patient age, gender, and surgical side were similar between the 2 groups. Recurrence of the DG at the second postoperative assessment was 1 of 41 patients in the arthroscopic group and none in the open excision group, and, after a minimum of 12 months after excision, recurrence was 3 of 28 in the arthroscopic group and 2 of 23 in the open group.

CONCLUSIONS

This study compares the rates of ganglion recurrence between arthroscopic and open DG excision. Our results demonstrate that at 12 months follow-up, the rates of recurrence with arthroscopic DG excision are comparable with and not superior to those of open excision. Our results suggest that additional long-term comparative studies are needed to accurately differentiate the efficacy of open and arthroscopic techniques.

摘要

目的

本研究旨在比较关节镜下与开放手术切除背侧腱鞘囊肿(DG)后的复发率。

方法

2名资深手外科医生中的1名对72例患者进行了原发性单纯DG的关节镜或开放切除手术。进行了3次前瞻性术后评估。第一次检查在术后5至7天进行,第二次在4至8周进行,第三次评估在术后至少1年进行。记录第二次和第三次评估时腱鞘囊肿的复发率。

结果

41例患者接受了关节镜下切除,31例患者接受了开放切除。两组患者的基线年龄、性别和手术部位相似。术后第二次评估时,关节镜组41例患者中有1例复发,开放切除组无复发;切除后至少12个月时,关节镜组28例中有3例复发,开放组23例中有2例复发。

结论

本研究比较了关节镜下与开放手术切除DG后的复发率。我们的结果表明,在12个月的随访中,关节镜下切除DG的复发率与开放切除相当,并不优于开放切除。我们的结果表明,需要进行更多的长期比较研究,以准确区分开放手术和关节镜技术的疗效。

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