Abstract
We analyzed the long-term results of endoscopic carpal tunnel release surgery using the Universal Subcutaneous Endoscope (USE) system for haemodialysis-associated carpal tunnel syndrome. A total of 388 hands/279 cases [mean age 52.3 years, mean dialysis duration 16.3 years, mean follow up period 7.4 years (5-15.5)] were followed for more than 5 years. We analyzed the clinical symptoms, tingling sensation, pain and touch sensation, recovery of abductor pollicis brevis (APB) muscle power, complications, and recurrence rate. There were no complications during our procedure. Recovery rates for tingling sensation (93%), pain sensation using a 3 gm. algesiometer (92%), and touch sensation using a 2gm. von Frey hair (90%) were recorded at 6 months postoperatively. Five-year recovery rates were 98%, 98%, and 97%, respectively. APB muscle grading at final follow up showed recovery to grades [4] or [5] on manual muscle testing in 85% of hands with preoperative grading levels of [0], [1], [2], or [3]. Twenty hands (5%) developed recurrence. The mean interval until recurrence was 7.6 years.
We compared the recovery rates of clinical symptoms (tingling, pain and touch sensations) between the recurrence group (20 hands) and the non-recurrence group (368 hands). We found no significant differences between the two groups. Endoscopic carpal canal release surgery using the USE system is safe and effective for treatment of long-term haemodialysis-related carpal tunnel syndrome patients.
