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We analyzed trends in open and endoscopic carpal tunnel release (CTR) from 2014 to 2019 using the National Database of Health Insurance Claims and Specific Health Checkups in Japan (NDB). Japan has a universal health insurance system and more than 95% of all claims are searchable in the NDB open data repository. The results revealed that nearly 40,...
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Context 1
... was a mild correlation coefficient for ECTRs and the number of hand surgery specialists by prefecture per population (r = 0.32, p = 0.04). However, the number of hand surgery specialists by prefecture and OCTR per population was not correlated (r = 0.06, p = 0.67) (Table S1). ...Context 2
... was a mild correlation coefficient for ECTRs and the number of hand surgery specialists by prefecture per population (r = 0.32, p = 0.04). However, the number of hand surgery specialists by prefecture and OCTR per population was not correlated (r = 0.06, p = 0.67) (Table S1). ...Context 3
... surgery was more common for both. ECTR had a higher proportion of outpatient procedures, but there was no significant difference (Table 1). Concerning outpatient and inpatient surgery, the former increased for both OCTR and ECTR, as shown in Figure 5. ...Similar publications
PurposeSmall bowel obstruction (SBO) is the most common indication for laparotomy in the UK. While general surgeons have become increasingly subspecialised in their elective practice, emergency admissions commonly remain undifferentiated. This study aimed to assess temporal trends in the management of adhesional SBO and explore the influence of sub...
Citations
... ECTR involves arthroscopic incision of the transverse carpal ligament using one or two portal sites. This technique is also reportedly superior to OCTR in patient satisfaction, key pinch strength, returnto-work time, and incidence of wound-related complications [10][11][12]. ...
Background
The purpose of this study was to examine two techniques for Carpal Tunnel Syndrome, mini-Open Carpal Tunnel Release (mini-OCTR) and Endoscopic Carpal Tunnel Release (ECTR), to compare their therapeutic efficacy.
Methods
Sixteen patients who underwent mini-OCTR in palmar incision and 17 patients who underwent ECTR in the wrist crease incision were included in the study. All patients presented preoperatively and at 1, 3, and 6 months postoperatively and were assessed with the Visual Analogue Scale (VAS) and the Disabilities of Arm, Shoulder and Hand Score (DASH). We also assessed the pain and cosmetic VAS of the entire affected hand or surgical wound, and the patient’s satisfaction with the surgery.
Results
In the objective evaluation, both surgical techniques showed improvement at 6 months postoperatively. The DASH score was significantly lower in the ECTR group (average = 3 months: 13.6, 6 months: 11.9) than in the mini-OCTR group (average = 3 months: 27.3, 6 months: 20.6) at 3 and 6 months postoperatively. Also, the pain VAS score was significantly lower in the ECTR group (average = 17.1) than in the mini-OCTR group (average = 36.6) at 3 months postoperatively. The cosmetic VAS was significantly lower in the ECTR group (average = 1 month: 15.3, 3 months: 12.2, 6 months: 5.41) than in the mini-OCTR group (average = 1 month: 33.3, 3 months: 31.2, 6 months: 24.8) at all time points postoperatively. Patient satisfaction scores tended to be higher in the ECTR group (average = 3.3) compared to the mini-OCTR group (average = 2.7).
Conclusions
ECTR in wrist increase incision resulted in better pain and cosmetic recovery in an early postoperative phase compared with mini-OCTR in palmar incision. Our findings suggest that ECTR is an effective technique for patient satisfaction.
... Isam Atroshi et al. stated that the most common group having carpel tunnel syndrome is average 44 years old 23 , current study results regarding common age group is also relatable to this study. Some studies shows that OCTR is more prevalent that ECTR 24 But some studies show that OCTR is only common in Midwest and ECTR is more prevalent in other areas. 25 So, the results of this study is also relatable to current study. ...
Objective: To compare the outcomes of open and endoscopic surgical interventions for CTS and determine the superiority of one technique over the other. Methodology: This is a descriptive cross-sectional study that analyzed data from 132 patients with Carpal Tunnel Syndrome who underwent open surgery or endoscopic surgery at a military hospital in Pakistan from July 2022 to January 2023. The study was approved by the University of Lahore's institutional review board and patients gave informed consent. Participants were between the ages of 25-60 and had a clinical and electrical diagnosis of CTS. Data was collected using a Performa and analyzed with SPSS V23. Results: The common age group for CTS surgery was 41-50 years and the frequency of CTS was higher in females (74.2%) than in males (25.8%). Endoscopic surgery was more common (53%) than open surgery (47%). Results on follow-up patients showed that complications were higher after open surgery compared to endoscopic surgery. Conclusion: The study concluded that endoscopic release procedure is superior to open procedure as it showed comparable results in alleviating symptoms, reducing severity, improving function, reducing pain and similar complications. Endoscopic procedure has benefits such as quicker return to daily activities, earlier return to work and smaller incision.
... Carpal tunnel syndrome (CTS) is the most common upper extremity compression neuropathy, and can cause permanent loss of sensation and partial paralysis of the thumb [1]. The prevalence of CTS under different case definitions ranges from 2.5% to 11.0% [2]. There are two conflicting hypotheses regarding the pathogenesis of CTS: one supports an edema-induced increase in carpal tunnel pressure, while another supports fibrosis of the subsynovial connective tissues in the carpal tunnel [3,4]. ...
IntroductionLocal steroid injection (LSI) in the carpal tunnel is a mainstay of conservative treatment in patients with carpal tunnel syndrome (CTS). Currently, clinicians generally perform a conventional proximal approach (PA) or novel distal approach (DA) for LSI. Recent systematic reviews comparing the two injection methods are lacking. This systematic review and meta-analysis aimed to assess whether LSI using the DA was superior to PA in treating patients with CTS.Methods
Databases including Pubmed, Embase, and the Cochrane library were searched up to 30 May 2022 to identify relevant randomized controlled trials (RCTs) comparing the DA with the PA steroid injection in patients with CTS. The outcomes mainly included Boston Carpal Tunnel Questionnaire Symptom Severity Scale (BCTQs) and Functional Status Scale (BCTQf), visual analog scores (VAS), electrophysiological outcomes, pain of injection, duration of injection, or adverse events.ResultsFive RCTs involving 339 patients were identified. Pooled analysis showed that the DA group took less time [mean difference (MD) −19.91; 95% CI −34.48 to −5.35; P = 0.007] and acquired better sensory nerve action potential amplitude [standardized mean difference (SMD) −0.37; 95% CI −0.62 to −0.11; P = 0.005]. The two groups were not significantly different in terms of BCTQs and BCTQf, VAS, other electrophysiological outcomes, pain of injection, or adverse events (P > 0.05).Conclusion
Although providing similar improvement in pain relief or function improvement, the distal approach is superior to the proximal approach in terms of timing, without increasing other side effects. Further high-quality randomized studies are required to confirm these results.
... However, there are concerns about the potential for transient or permanent nerve injury. In the study of Yamamoto et al. [13], the annual open and endoscopic carpal tunnel release figures of Japan were documented, and their trends, gender differences, age distributions, and regional variations were analyzed. The results show that almost 40,000 CTRs were performed annually in Japan, and open CTR was implemented nearly four times more often than endoscopic CTR. ...
This current Special Issue of JCM will highlight some of the latest studies on carpal tunnel syndrome (CTS) [...]
The Ministry of Health, Labour, and Welfare, Japan launched a national administrative claims database in 2009, which is called the National Database of Health Insurance Claims and Specific Health Checkups of Japan (NDB). Detailed information on the NDB was reported in Annals of Clinical Epidemiology in 2019. The present report provides updated information on the NDB. In 2020, the provision of data to private companies, as well as public sectors and academic entities, was legislated. As of 2024, the Ministry of Health, Labour, and Welfare is planning linkage of NDB data with several other national databases. Our previous literature review identified a total of 126 original articles using the NDB and NDB Open data published from 2013 to 2022. Our updated review identified 94 original articles using the NDB and NDB Open Data in the recent two years. Studies using the NDB are gradually increasing, but there is still room for enhancing NDB studies on various subject areas.
Purpose
The aim of this systematic review and meta-analysis was to evaluate the safety and effectiveness of endoscopic carpal tunnel release (ECTR) using best-evidence synthesis methods.
Methods
A systematic search of multiple databases was conducted for prospective contemporary studies published between January 2013 and January 2023 with at least 50 ECTR cases. Outcomes included the Quick Disabilities of the Arm, Shoulder, and Hand Questionnaire (Q-DASH) measured on a 0–100 scale, Boston Carpal Tunnel Questionnaire Symptom Severity Scale (BCTQ-SSS) and Functional Status Scale (BCTQ-FSS) on a 1–5 scale, pain visual analog scale on a 0–10 scale, conversion to open carpal tunnel release (CTR), complications, and reoperations. Outcomes were analyzed using a random-effects meta-analysis model. Metaregression was used to determine the association of patient- and study-level factors with ECTR outcomes.
Results
A total of 17 studies with 1,632 patients treated with ECTR were included. Median follow-up durations ranged from 4 to 7 months depending on the outcome. Statistically significant and clinically important improvements were noted after ECTR for Q-DASH, BCTQ-SSS, BCTQ-FSS, and pain visual analog scale scores, with mean differences from baseline of −28.8, −1.8, −1.5, and −5.1, respectively (P < .001 for all). In metaregression, the strongest predictor of improvement in Q-DASH, BCTQ-SSS, and BCTQ-FSS was a greater preoperative score for that variable (all P ≤ .005), indicating that patients with worse symptoms improved the most. The risks of conversion to open CTR, complications, and revision CTR were 0.7%, 0.7%, and 0.5%, respectively.
Conclusions
In a best-evidence synthesis of contemporary studies, ECTR resulted in significant improvements in function and pain, with a low risk of conversion to open surgery, complications, and reoperations over short-term follow-up.
Clinical relevance
Patients treated with ECTR can expect generally favorable clinical outcomes over the short term. However, long-term outcomes after ECTR are not well characterized.
Purpose: Carpal tunnel syndrome (CTS) is a condition in which the median nerve is compressed between the transverse ligament and the carpal bones. There are various techniques used in the surgical treatment of CTS. The present study aimed to investigate the reasons for reoperation by examining the reoperated cases diagnosed with CTS. Materials and Methods: Patients who underwent surgery for CTS at Kahramanmaraş Sütçü İmam University Department of Neurosurgery between January 1, 2015 and September 1, 2022 were evaluated retrospectively. Patients who underwent two or more operations with the same diagnosis were included in the study, while those operated for the first time due to CTS and with missing data were excluded. The included patients were analyzed in terms of gender, age, occupation, side of the surgery, presence of systemic diseases causing CTS such as diabetes mellitus (DM), number of the operations they underwent, time until the next operation, surgical technique, and medical branch that performed the surgery (orthopedics, neurosurgery, or plastic surgery). Findings: Forty-eight patients who met the study criteria were evaluated. Out of the 48 reoperated patients, 14 were male and 34 were female. Eighteen patients had been operated using the mini-incision open method, while 22 had undergone laparoscopic surgery, including 14 patients with biportal endoscopic surgery, and eight with uniportal endoscopic surgery. Out of the 48 patients, 31 (64.6%), 11 (22.9%), and six patients were first operated by orthopedic and traumatology physicians, plastic and reconstructive surgeons, and neurosurgeons, respectively. Conclusion: The use of open surgical technique is the gold standard in CTS and complete incision of the transverse ligament provides complete decompression of the median nerve. We believe that decompression with closed or small incisions due to aesthetic concerns may not be sufficient and may increase the risk of complications.
