Clinical Evaluation Of The Two-portal Endoscopic Surgery And A Modified Mini-incision Surgery In The Treatment Of Carpal Tunnel Syndrome

ObjectiveA single-center randomized prospective study was conducted to compare and evaluate the postoperative clinical efficacy of minimally invasive treatment of a carpal tunnel syndrome by two-portal endoscopic surgery and a modified mini-incision surgery.MethodsPatients eligible for inclusion from May 2019 to July 2020 were randomly divided into two groups,who were treated with two-portal endoscopic surgery and a modified mini-incision surgery for carpal tunnel syndrome.Patients were followed up for more than half a year after surgery.Postoperative hospital stays,surgical cost,length of incision,postoperative wound infection,wrist swelling,scar pain,median nerve recurrent branch injury,and relapse after symptom relief were recorded in the two groups.Boston carpal tunnel scale(BCTQ)score was performed for all patients.ResultsThe operation cost of the endoscopic group was higher than that of the mini-incision group.Under conventional operation,each endoscopic group spent1500 yuan more than that of the mini-incision group.Further,the operative incision length of the endoscopic group was(0.71±0.01)cm,and that of the mini-incision group was(1.52 ± 0.02)cm,and the difference was significant(P < 0.05).The postoperative hospitalization time of the endoscopic group was(2.32±0.61)day,and that of the mini-incision group was(2.39 ± 0.50)day.There was no statistical difference between the two groups(P > 0.05).Furthermore,there were 2 cases of obvious scar pain in the two-portal endoscopy group and 4 cases in the modified mini-incision group,and there was no statistically significant differences between the two groups(P > 0.05).The incidence of wrist swelling was analyzed,including 4cases in the endoscopic group and 3 cases in the small incision group.There was no statistically significant difference between the two groups(P > 0.05).After 6 months of follow-up,the patient’s scar pain and wrist swelling were improved and disappeared.Moreover,significant differences in Boston carpal tunnel scale(BCTQ)scores were noticed at 1 month,3 months and 6 months after surgery(P < 0.05),but no significant differences between groups(P >0.05).No postoperative infection,median nerve recurrent branch injury,or recurrence after symptom relief occurred in all the patients.ConclusionModified mini-incision surgery has presented the advantages of minimally invasive,good postoperative healing,less complications and short learning curve.Under the standardized operation,the postoperative patients of two-portal endoscopic surgery have good clinical efficacy,including good healing,fewer complications,and more minimally invasive incision than modified mini-incision surgery.Meanwhile,endoscopic surgery showed high requirements on equipment,longer learning curve for the operator,and heavier consumption burden for the patient.There was no significant difference in the clinical efficacy between two-portal endoscopic surgery and modified mini-incision surgery in the treatment of carpal tunnel syndrome.Endoscopic surgery requires the operator to traditional open surgery and carpal tunnel anatomy of the master.Also,a longer learning curve,and the improved requirement for equipment is low.Modified mini-incision surgery in relatively poor conditions of basic-level hospitals also can be carried out.Therefore,modified mini-incision surgery method could be the better choice for the most hospitals.