From the Departments of Plastic Surgery and Orthopedic Surgery, University of Texas Southwestern Medical Center.
Plast Reconstr Surg. 2018 Nov;142(5):718e-721e. doi: 10.1097/PRS.0000000000004844.
Arthroscopic dorsal wrist ganglionectomy is an established alternative to open excision in the adult population. The purpose of this study was to retrospectively compare outcomes of arthroscopic and open dorsal wrist ganglionectomy in the pediatric population.
All patients who underwent arthroscopic or open dorsal wrist ganglionectomy at a single pediatric institution between 2011 and 2014 were retrospectively evaluated by chart review and telephone interview. The primary outcome variable was whether or not the cyst had recurred. Other outcome measures included the incidence of complications, and patient-rated outcome measures such as satisfaction, pain, function, and aesthetics.
There were eight cases of arthroscopic and 19 cases of open ganglionectomy, with a mean age of 14 years. At an average follow-up of 2 years, the recurrence rate was one of eight for the arthroscopic group and two of 19 for the open group. No patients in the arthroscopic group reported functional limitations, compared with three patients in the open group. On a 10-point scar appearance scale, with 1 being not satisfied at all and 10 being highly satisfied, the median score in the arthroscopic group was 9.5, compared with 8 in the open group. No patients in the arthroscopic group had residual pain at the surgical site, compared with nine patients in the open group, a finding that was statistically significant. All patients in the arthroscopic group reported that they would undergo surgery again, whereas two patients in the open group would not undergo surgery again.
Arthroscopic dorsal wrist ganglionectomy compares favorably with open ganglionectomy in the pediatric population.
关节镜下腕背腱鞘囊肿切除术已成为成人腱鞘囊肿的一种成熟的替代治疗方法。本研究旨在回顾性比较小儿腱鞘囊肿患者关节镜下与开放手术切除的疗效。
本研究通过病历回顾和电话访谈，对 2011 年至 2014 年间在一家儿童医院接受关节镜或开放腕背腱鞘囊肿切除术的所有患者进行了回顾性评估。主要的观察变量是囊肿是否复发。其他的观察指标包括并发症的发生率，以及患者的评估指标，如满意度、疼痛、功能和美观。
本研究共纳入 8 例关节镜下和 19 例开放腱鞘囊肿切除术患者，平均年龄为 14 岁。平均随访 2 年后，关节镜组的复发率为 1/8，开放组为 2/19。关节镜组无患者报告功能受限，而开放组有 3 例。在 10 分瘢痕外观评分中，1 分为非常不满意，10 分为非常满意，关节镜组的中位数评分为 9.5，而开放组为 8。关节镜组无患者手术部位残留疼痛，而开放组有 9 例，差异有统计学意义。关节镜组所有患者均表示愿意再次手术，而开放组有 2 例患者不愿意再次手术。
关节镜下腕背腱鞘囊肿切除术在小儿腱鞘囊肿患者中与开放手术切除相比具有优势。
