Question:I had a ganglion removed from my wrist last year. The surgeon did it arthroscopically (instead of making an open incision). Now the darn thing has grown back. Was I wrong not to have the full, open surgery?
Answer:Wrist ganglions are known to return no matter how the operation is performed. A recent study comparing open surgery to arthroscopic (minimally invasive) surgery showed no difference in return rates of the ganglion.
In fact, the study may have brought to light new information about recurrence. It was always thought that the ganglion comes back when the stalk of the cyst isn't fully removed. But when open surgery was compared with an arthroscopic approach, there was no difference in recurrence rates.
In the study, the cyst was removed down to the base of the stalk during open surgery. The cyst and stalk were removed during the arthroscopic procedure. These results lead surgeons to think perhaps the real cause of ganglion recurrence is multifactorial.
More study is needed to understand why there is such a wide range (2 to 40 per cent) of ganglion recurrence after surgical removal. At this point, it doesn't look likely that the surgical approach (open versus closed) is a factor.Lana King, MD, et al. Arthroscopic Versus Open Dorsal Ganglion Excision: A Prospective, Randomized Comparison of Rates of Recurrence and of Residual Pain. In The Journal of Hand Surgery. April 2008. vol. 33A. No. 4. Pp. 471-475.
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