Almojel Yazeed A, Alhathlol Hussam A, Asery Yazeed A, Nahhas Nawaf K, Alhumaidan Mohammed I, Almaghrabi Maan, Alqarni Mohammed D, Alsahli Alaa, Alhassan Turki S
From the College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Plastic Surgery Department, NGHA-KAMC, Riyadh, Saudi Arabia.
Plast Reconstr Surg Glob Open. 2025 Jun 23;13(6):e6887. doi: 10.1097/GOX.0000000000006887. eCollection 2025 Jun.
Surgical decompression of carpal tunnel syndrome by the standard open carpal tunnel release (OCTR) technique was associated with postoperative pain and tenderness. Thus, the endoscopic carpal tunnel release (ECTR) has been introduced to reduce the complications of open surgery through a shorter incision to decrease scar pain and achieve rapid recovery. In this study, we aimed to compare the outcomes between OCTR and ECTR, according to randomized controlled trial evidence.
A systematic literature search was conducted in PubMed, Web of Science, EBSCO, and Cochrane Central Register of Controlled Trials (CENTRAL) databases. Meta-analysis was performed using Comprehensive Meta-analysis software. Standard mean difference and a 95% confidence interval were used for continuous outcomes, whereas odds ratio with 95% confidence intervals were utilized for dichotomous outcomes.
A total of 34 studies were included. ECTR has shown significant lower rates of scar pain and significant shorter recovery compared OCRT. However, we could not find any significant difference between the groups in terms of complication rates, incidences of local pain, mean pain scores, subjective complete or near complete symptom relief rate, subjective complete satisfaction rate, mean satisfaction scores, mean scores of symptom severity, mean scores of functional status, and mean time of operation.
Both ECTR and OCTR are safe and effective in management of carpal tunnel syndrome. However, ECTR may be slightly superior in terms of scar pain and postoperative recovery, although other factors not included in this study, including cost and convenience, must be considered.
采用标准开放式腕管松解术（OCTR）治疗腕管综合征，术后会出现疼痛和压痛。因此，内镜下腕管松解术（ECTR）应运而生，通过缩短切口来减少开放手术的并发症，减轻瘢痕疼痛，实现快速恢复。在本研究中，我们旨在根据随机对照试验证据比较OCTR和ECTR的治疗效果。
在PubMed、科学网、EBSCO和Cochrane对照试验中心注册库（CENTRAL）数据库中进行系统的文献检索。使用Comprehensive Meta-analysis软件进行荟萃分析。连续变量结果采用标准均差和95%置信区间，二分变量结果采用95%置信区间的比值比。
共纳入34项研究。与OCRT相比，ECTR的瘢痕疼痛发生率显著更低，恢复时间显著更短。然而，在并发症发生率、局部疼痛发生率、平均疼痛评分、主观完全或接近完全症状缓解率、主观完全满意率、平均满意度评分、症状严重程度平均评分、功能状态平均评分和平均手术时间方面，两组之间未发现任何显著差异。
ECTR和OCTR在治疗腕管综合征方面均安全有效。然而，ECTR在瘢痕疼痛和术后恢复方面可能略具优势，不过本研究未涵盖的其他因素，包括成本和便利性，也必须予以考虑。
