Abstract
Carpal tunnel syndrome (CTS) in long-term haemodialysis patients is caused by haemodialysis amyloidosis. Because of this pathogenesis, the symptoms are progressive and spontaneous recovery does not occur. In these patients, surgical treatment is required. We have performed endoscopic carpal canal release using the Universal Subcutaneous Endoscope (USE) system since 1986. With our minimally invasive procedure, we can achieve optimal results in haemodialysis patients as well as those with idiopathic cases. In haemodialysis patients, however, continued maintenance haemodialysis causes further deposition of amyloid and the recurrence rate of carpal tunnel syndrome in such patients is five percent. We divided patients who received primary endoscopic carpal canal release and were followed for more than six months into two groups, a recurrent group and a nonrecurrent group, then compiled and statistically analyzed the mean age at primary surgery, mean duration of haemodialysis, incidence of bilateral CTS and arterio-venous shunt side. There were significant differences in mean age and mean duration of haemodialysis between the two groups. In haemodialysis-related CTS, the surgical procedure should be minimally invasive because of the possibility of recurrence. Therefore, our endoscopic procedure should be the first treatment choice for long-term haemodialysis patients with CTS.
