Medical University of South Carolina, Charleston, USA.
University of Kansas Medical Center, Kansas City, USA.
Hand (N Y). 2024 Jan;19(1):128-135. doi: 10.1177/15589447221107693. Epub 2022 Jul 15.
Open carpal tunnel release (OCTR) and endoscopic carpal tunnel release (ECTR) are the 2 operative approaches used to treat carpal tunnel syndrome (CTS). This study aims to identify whether differences between OCTR and ECTR rates exist, and, if so, are these differences associated with patient demographics or hospital characteristics.
The 2018 Nationwide Ambulatory Surgery Sample (NASS) was filtered for patient encounters including either OCTR or ECTR operations. All patients undergoing either OCTR or ECTR were included, regardless of surgical specialty. Patient demographics and hospital characteristics data, provided and predefined by the NASS database, were collected and compared between the 2 treatment groups.
A total of 180 740 patient encounters were collected for both procedure types (OCTR: 62.4% women, mean age, 58 years; ECTR: 62.2% women, mean age, 58 years). Patients from lower income zip codes were more likely to undergo OCTR ( < .001). Patients either self-paying ( < .008) or covered by Medicare ( < .001) or Medicaid insurance ( < .001) were also more likely to undergo OCTR. In contrast, patients who received care at academic centers and centers with >300 beds were more likely to undergo ECTR ( < .001). Patients <65 years old were more likely to undergo ECTR ( < .001), and patients > 75 years old were more likely to undergo OCTR ( < .001). In addition, ECTR was found to be more expensive, with average total charges $1568 greater than charges for OCTR ( < .001).
Significant differences exist in treatment strategies for CTS and are related to patient income, location, and primary payor status. Differences in OCTR and ECTR rates are also present, and are related to the size and academic status of hospitals.
开放性腕管松解术（OCTR）和内镜腕管松解术（ECTR）是治疗腕管综合征（CTS）的两种手术方法。本研究旨在确定 OCTR 和 ECTR 之间是否存在差异，如果存在，这些差异是否与患者人口统计学特征或医院特征有关。
从 2018 年全国门诊手术样本（NASS）中筛选出包括 OCTR 或 ECTR 手术的患者就诊记录。所有接受 OCTR 或 ECTR 手术的患者均被纳入研究，无论手术专业如何。收集并比较了两组患者的人口统计学特征和医院特征数据，这些数据是由 NASS 数据库提供和预先定义的。
共收集了 180740 例两种手术方式的患者就诊记录（OCTR：62.4%为女性，平均年龄 58 岁；ECTR：62.2%为女性，平均年龄 58 岁）。来自收入较低邮编地区的患者更倾向于接受 OCTR（<0.001）。自费（<0.008）或由医疗保险（<0.001）或医疗补助保险（<0.001）支付的患者也更倾向于接受 OCTR。相比之下，在学术中心和拥有 300 张以上床位的中心接受治疗的患者更倾向于接受 ECTR（<0.001）。<65 岁的患者更倾向于接受 ECTR（<0.001），而>75 岁的患者更倾向于接受 OCTR（<0.001）。此外，ECTR 的费用更高，总费用比 OCTR 高出 1568 美元（<0.001）。
CTS 的治疗策略存在显著差异，与患者的收入、所在地和主要支付方状态有关。OCTR 和 ECTR 之间的差异也存在，并且与医院的规模和学术地位有关。
