论文部分内容阅读
PURPOSE: To evaluate the efficacy,functional outcomes and safety after both endoscopic carpal tunnel release(ECTR)and open carpal tunnel release(OCTR)in the opposite hands of the same patients using a meta‐analysis of data from randomized controlled trials. MATERIALS AND METHODS: Electronic searches of the Cochrane Register of Controlled Trials,PUBMED,and EMBASE(published between 1966 and June 2015)were used to identify randomized controlled trials that evaluated endoscopic vs open methods used in the opposite hands for treatment of bilateral carpal tunnel release.Studies to be used were independently identified by two researchers.The methodological quality of the studies was assessed by the Cochrane Collaboration tool for assessing risk of bias.Pooled relative risk(RR)and 95%confidence intervals(CIs)for safety and efficacy outcome variables were calculated by fixed‐effect or random‐effect methods with RevMan v.5.1.Five randomized controlled trials involving 142 patients with bilateral CTS were included. RESULTS: This meta‐analysis indicated that ECTR resulted in significantly better Boston Carpal Tunnel Questionnaire functional status scores(BCTQ‐f)than OCTR(RR = 0.13,95%CI [0.02 to 0.25]; p = 0.02),but did not significantly increase the symptom severity scores(BCTQ‐s)(RR = 0.06,95%CI [‐0.15 to 0.04]; p = 0.25).ECTR needed more operative time(RR = -1.27,95%CI [-2.22 to ‐0.33],P = 0.008)compared with OCTR,the results also indicated that there were no statistical differences between the two procedures in VAS pain scores(RR = 0.02,95%CI [‐0.08 to 0.11]; p = 0.75),hand grip strength(RR = 0.17,95%CI [‐2.03 to 2.37]; p = 0.88),digital sensibility static 2PD(RR = 0.34,95%CI [‐0.03 to 0.70]; p = 0.07)and complication rates(RR = 0.01,95%CI [‐0.02 to 0.05],P = 0.47). CONCLUSION: Our meta‐analysis specifically included the randomized controlled trials compared the patients who have bilateral CTS experience OCTR in one hand and ECTR in another,demonstrated that ECTR and OCTR were similar in relief of symptoms,recovery of hand strength and sensibility.ECTR resulted in better recovery of daily life function but need more operative time than OCTR,and both ECTR and OCTR are safe for CTS patients.