Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, PR China.
Department of Orthopedics, The Second Hospital of Shanxi Medical University, Taiyuan, PR China.
Int J Surg. 2016 Nov;35:104-110. doi: 10.1016/j.ijsu.2016.09.012. Epub 2016 Sep 12.
We conducted this systematic review and meta-analysis to compare the clinical efficacy and safety between open and endoscopic in situ decompression surgery methods for cubital tunnel syndrome (CuTS).
PubMed, Medline, Embase, Cochrane Library and CNKI were searched for eligible studies. The data were extracted by two of the coauthors (WL, BYF) independently and were analyzed using RevMan statistical software, version 5.1. Relative risks (RRs) and 95% confidence intervals (CIs) were calculated. Cochrane Collaboration's Risk of Bias Tool and the Newcastle-Ottawa Scale were used to assess the risk of bias.
Seven studies were included for systematic review, and six studies were included for meta-analysis. The CuTS patients received open in situ decompression (OISD) or endoscopic in situ decompression (EISD). A pooled analysis of postoperative Bishop score showed that the difference was not statistically significant between the EISD group and the OISD group (RR = 0.99, 95% CI = 0.88-1.12, P = 0.88). The overall estimate of postoperative satisfaction between the EISD group and the OISD group was not found to be significant (RR = 0.98, 95% CI = 0.89-1.08, P = 0.70). The overall estimate of complications (RR = 0.88, 95% CI = 0.24-3.29, P = 0.85) suggested that the difference was not statistically significant.
EISD and OISD for treating CuTS have equivalent efficacy for postoperative clinical improvement, whereas the incidences of complications of endoscopic surgical procedure were also same as those with the open surgical procedure. In situ decompression (especially EISD, with minor intraoperative trauma) could be treated as a valuable alternative to treat CuTS.
本系统评价和荟萃分析旨在比较肘管综合征（CuTS）开放式和内镜下原位减压手术方法的临床疗效和安全性。
检索PubMed、Medline、Embase、Cochrane 图书馆和中国知网（CNKI）以获取符合条件的研究。由两位共同作者（WL、BYF）独立提取数据，并使用 RevMan 统计软件版本 5.1 进行分析。计算相对风险（RR）和 95%置信区间（CI）。使用 Cochrane 协作风险偏倚工具和纽卡斯尔-渥太华量表评估偏倚风险。
共纳入 7 项研究进行系统评价，6 项研究进行荟萃分析。CuTS 患者接受开放式原位减压（OISD）或内镜下原位减压（EISD）。术后 Bishop 评分的汇总分析显示，EISD 组与 OISD 组之间的差异无统计学意义（RR=0.99，95%CI=0.88-1.12，P=0.88）。EISD 组与 OISD 组之间术后满意度的总体估计值无显著差异（RR=0.98，95%CI=0.89-1.08，P=0.70）。并发症的总体估计值（RR=0.88，95%CI=0.24-3.29，P=0.85）表明差异无统计学意义。
EISD 和 OISD 治疗 CuTS 在术后临床改善方面具有等效疗效，而内镜手术的并发症发生率也与开放手术相同。原位减压（尤其是 EISD，术中创伤较小）可作为治疗 CuTS 的一种有价值的替代方法。
