PATIENT OUTCOMES FOLLOWING WRIST GANGLION EXCISION SURGERY

Abstract

Wrist ganglia are the commonest benign tumours of the hand consisting of a collagenous walled cavity containing gelatinous mucin material. These lesions can be managed by either reassurance alone, aspiration or surgical excision. However studies evaluating patient outcomes following these treatment modalities are limited and between them have often presented inconsistent results. Some recently published data has suggested that there is no long-term benefit of excision or aspiration over reassurance alone and as a result surgical excision of wrist ganglia has fallen out of favour with some health care trusts.

This aim of this retrospective, questionnaire based study was to assess patient outcomes following wrist ganglion excision surgery and to compare these results with current published evidence. Sixty two patients were identified from the hospital records database between July 2003 and March 2008. Fifty patients (80.6%) responded to a questionnaire by post or telephone call with a mean time to follow up of thirty nine months (range 16 to 71 months). Pain and cosmetic concern were the primary symptoms preoperatively, experienced by 78% and 70% of patients respectively. 26% to 48% of patients experienced other symptoms such as pins and needles, numbness, weakness and stiffness. Following surgery, there was a statistically significant reduction in all symptoms experienced. Ganglions recurred at the same location in five patients (12%) of which four would consider further surgery. 96% of patients were satisfied with the treatment they received.

Our results regarding symptomatic relief are comparable with current published data. In addition our data provides further evidence that ganglion excision surgery prevents recurrence to a greater extent than either aspiration or reassurance alone. Furthermore our recurrence rate is lower than other published reports evaluating ganglion excision surgery which we believe underestimate the benefits offered by this treatment modality. As a result, wrist ganglion excision surgery remains an important treatment modality offering excellent results in terms of symptom resolution, patient satisfaction and ganglion recurrence.