Tek Merkezde 14 Yıllık El ve El Bilek Ganglionları Deneyimi

Yıl 2022, Cilt: 12 Sayı: 1, 11 - 15, 18.03.2022

Ali Cavit , Osman Civan , Haluk Özcanlı

https://doi.org/10.31832/smj.1037576

Öz

Amaç: Çalışmamızda, tek merkezde, 14 yıllık bir sürede, ganglion ön tanısı ile opere edilen geniş bir hasta popülasyonunun klinik değerlendirilmesi amaçlanmaktadır.

Gereç ve Yöntemler: El ve el bileği yerleşimli ganglion kisti ön tanısı ile ameliyat edilen ve histopatolojik olarak tanısı konulan 167 hasta çalışmaya dahil edildi. Yaş, cinsiyet, lokalizasyon, klinik prezentasyonlar, ameliyat edilen taraf, tedavi yöntemleri ve histopatolojik özellikler retrospektif olarak değerlendirildi. Telefon görüşmeleri ile nüksler, komplikasyonlar ve sonuçlar değerlendirildi. İstatistiksel analizler ve tanımlayıcı istatistikler sıklık ve yüzdelerle sunuldu.

Bulgular: Hastaların ortalama yaşı 40,70 yıl idi (dağılım, 3-83 yıl). Hastaların büyük çoğunluğu (%62,87; n: 105) 2. - 4. dekatta idi. Hastaların temel şikayetleri ağrı ve kozmetik kaygılardı. Ganglionların büyük çoğunluğu (%68,26; n: 114) el bilek yerleşimli idi; bunlar da çoğunlukla el bilek dorsalinde yerleşmişlerdi (n: 65). Telefonla arandığında ulaşılabilen ve çalışmamıza katılmayı kabul eden 85 hastanın ortalama takip süresi 8,60 yıl idi. Bu hastalarda nüks oranı %7 idi (n: 6).

Sonuç: Çalışmamızın sonuçları; hastaların yaş dağılımı, cinsiyet baskınlığı ve ganglion lokalizasyonu açısından daha önce bildirilen çalışmaların bulguları ile tutarlıydı. Düşük nüks oranlarına kistin sapını ve bağlı olduğu dokunun bir kısmını da içerecek şekilde bir bütün olarak çıkarılmasıyla ulaşılabilir.

Anahtar Kelimeler

Ganglion, Kist, El, El bilek, Nüks

Single-Center, 14-Year Experience of Ganglions of the Hand and Wrist

Öz

Objective: The aim of present study is to evaluate a large clinical population of patients operated with diagnosis of ganglion in a single center over a 14-year period.

Materials and Methods: One hundred and sixty-seven patients operated and histopathologically diagnosed with ganglion cyst located in hand and wrist were included in the study. The retrospectively analyzed parameters included age, gender, localization, clinical presentations, site, treatment methods and histopathological features. Recurrences, complications and outcomes were evaluated by phone calls. Statistical analyses and descriptive statistics were presented with frequencies and percentages.

Results: The average age of the patients was 40,70 years (range 3-83 years). Majority of the patients (62,87%; n: 105) were in the 2nd – 4th decade of life. Pain and cosmetic concerns were the main complaints of the patients. The majority of the ganglions were located in the wrist (n: 114; 68,26%), and the majority of the wrist location was the dorsal side (n: 65). Mean follow-up time of 85 patients who could be reached by phone and agreed to participate in the study was 8,60 years. Recurrence rate among these patients was 7% (n: 6).

Conclusion: The results of the present study were consistent with findings reported previously respect to patient age distribution, gender predominance and ganglion localization. Low recurrence rates can be achieved by complete resection of the cyst including the stalk and a cuff of adjacent tissue.

Anahtar Kelimeler

Ganglion, Csyt, Hand, Wrist, Recurrence

Kaynakça

• Henderson M, Neumeister MW, Bueno RA Jr. Hand tumors: I. Skin and Soft-tissue tumors of the hand. Plast Reconstr Surg. 2014;133:154-64.
• Head L, Gencarelli JR, Allen M, Boyd KU. Wrist ganglion treatment: systematic review and meta-analysis. J Hand Surg Am. 2015 Mar;40(3):546-53. doi: 10.1016/j.jhsa.2014.12.014.
• Athanasian EA. Bone and soft tissue tumors. In: Wolfe SW, Hotchkiss RN, Pederson WC, Kozin SH, editors. Green’s operative hand surgery. 6th ed. Philadelphia: Churchill Livingstone; 2011. 2141-97.
• Nahra ME, Bucchieri JS. Ganglion cysts and other tumor related conditions of the hand and wrist. Hand Clin. 2004;20:249-60.
• Suen M, Fung B, Lung CP. Treatment of ganglion cysts. ISRN Orthop. 2013 May 28;2013:940615. doi: 10.1155/2013/940615.
• Gude W, Morelli V. Ganglion cysts of the wrist: pathophysiology, clinical picture, and management. Curr Rev Musculoskelet Med. 2008;1(3-4):205-211.
• Crawford C, Keswani A, Lovy AJ, et al. Arthroscopic versus open excision of dorsal ganglion cysts: a systematic review. J Hand Surg Eur Vol. 2018;43(6):659-664.
• Zeidenberg J, Aronowitz JG, Landy DC, Owens PW, Jose J. Ultrasound guided aspiration of wrist ganglions: a follow-up survey of patient satisfaction and outcomes. Acta Radiol 2016;57(04):481–486.
• Stephen AB, Lyons AR, Davis TR. A prospective study of two conservative treatments for ganglia of the wrist. J Hand Surg Br. 1999;24:104–105.
• Abe Y, Watson HK, Renaud S. Flexor tendon sheath ganglion: Analysis of 128 cases. Hand Surg. 2004;9:1–4.
• Kuliński S, Gutkowska O, Mizia S, Gosk J. Ganglions of the hand and wrist: Retrospective statistical analysis of 520 cases. Adv Clin Exp Med Jan-Feb 2017;26(1):95-100. doi: 10.17219/acem/65070.
• Rollins KE, Ollivere BJ, Johnston P. Predicting successful outcomes of wrist and finger ganglia. Hand Surg. 2013;18:41–44.
• Dermon A, Kapetanakis S, Fiska A, Alpantaki K, Kazakos K. Ganglionectomy without repairing the bursal defect: Long-term results in a series of 124 wrist ganglia. Clin Orthop Surg. 2011;3:152–156.
• Singhal R, Angmo N, Gupta S, Kumar V, Mehtani A. Ganglion cysts of the wris: A prospective study of a simple outpatient management. Acta Orthop Belg. 2005;71:528–534.
• Shoaib A, Clay NR. Ganglions. Curr Orthop. 2002;16:451–461.
• Meena S, Gupta A. Dorsal wrist ganglion: Current review of literature. J Clin Orthop Trauma 2014 Jun;5(2):59-64. doi: 10.1016/j.jcot.2014.01.006.
• Osterman AL, Raphael J. Arthroscopic treatment of dorsal ganglion of the wrist. Hand Clin. 1995;11:7e12.
• Jagers M, Akkerhuis O, Van Der Heijden M, Brink P. Hyaluronidase versus surgical excision of ganglia: a propsective, randomized clinical trial. J Hand Surg Br. 2002;27(3):256e258.
• Razemon JP. Surgical treatment of ganglions of the wrist by partial excision of the joint capsule. Report on 303 cases. Ann Chir Main 1983;2:230–243.
• Clay NR, Clement DA. The treatment of dorsal wrist ganglia by radical excision. J Hand Surg 1988;13B:187–191.