Department of Neurosurgery and Innovative Medicine, Irkutsk State Medical University, 1 Krasnogo Vosstaniya Street, Irkutsk, Irkutskaya Oblast, 664003, Russia.
Department of Neurosurgery, Irkutsk Scientific Center of Surgery and Traumatology, 1 Bortsov Revolutsii Street, Irkutsk, Irkutskaya Oblast, 664003, Russia.
Acta Neurol Belg. 2020 Feb;120(1):1-8. doi: 10.1007/s13760-019-01149-9. Epub 2019 May 7.
To examine whether endoscopic in situ decompression (EISD) or open in situ decompression (OISD) would have superior outcomes with lower morbidity in patients with idiopathic cubital tunnel syndrome, we reviewed all studies compared both surgical techniques with regard to postoperative outcomes and complication profile in a systematic review design with meta-analysis. Two independent reviewers conducted a PRISMA-compliant search of PubMed, EMBASE, and the Cochrane Library databases for relevant studies about clinical comparisons of OISD and EISD in cubital tunnel syndrome. We performed all meta-analyses with the Review Manager 5.3 software. For dichotomous variables, the risk ratio (RR) and 95% confidence intervals (CIs) were calculated. For continuous variables, the mean difference (MD) and 95% CIs were calculated. The level of significance was set as p < 0.05. Finally, 8 articles with 582 patients finally were included in this meta-analysis. Pooled analysis showed that the difference in Bishop score, visual analogue scale score reduction, postoperative satisfaction, postoperative hematoma rate and secondary surgical procedures were not statistically significant between the EISD group and the OISD group (p > 0.05). However, pooled results showed that patients who underwent EISD had a greater improvement in the scar tenderness/elbow pain than did those who underwent OISD with statistical significance (p < 0.0001). This meta-analysis demonstrated that EISD and OISD for surgical treating cubital tunnel syndrome had equivalent efficacy regarding postoperative clinical recovery, whereas the incidences of adverse events of EISD were also same as those with the OISD technique.
为了研究内镜下原位减压术（EISD）或开放式原位减压术（OISD）在治疗特发性肘管综合征时，哪种方法的术后结果更好、发病率更低，我们系统地回顾了所有比较这两种手术技术的研究，并对术后结果和并发症情况进行了荟萃分析。两位独立的审查员在 PRISMA 合规性搜索中，对 PubMed、EMBASE 和 Cochrane 图书馆数据库中有关 OISD 和 EISD 在肘管综合征中的临床比较的相关研究进行了搜索。我们使用 Review Manager 5.3 软件对所有的荟萃分析进行了分析。对于二分类变量，计算了风险比（RR）和 95%置信区间（CI）。对于连续性变量，计算了平均差异（MD）和 95%CI。显著性水平设定为 p<0.05。最终，纳入了 8 篇文章的 582 名患者进行了这项荟萃分析。汇总分析表明，EISD 组和 OISD 组在 Bishop 评分、视觉模拟评分降低、术后满意度、术后血肿发生率和二次手术率方面的差异无统计学意义（p>0.05）。然而，汇总结果表明，与接受 OISD 的患者相比，接受 EISD 的患者的疤痕压痛/肘部疼痛有更大的改善，差异具有统计学意义（p<0.0001）。这项荟萃分析表明，EISD 和 OISD 治疗肘管综合征的手术效果相当，术后临床恢复情况相似，而 EISD 的不良事件发生率与 OISD 技术相同。
