Purpose: Glucagon-like peptide-1 receptor agonist (GLP-1RA) use continues to rise because of its efficacy in glycemic control and weight reduction. There are sparse data on the implications of GLP-1RA therapy on surgical outcomes. Given the higher prevalence of carpal tunnel syndrome in patients with diabetes mellitus, obesity, or both, this study evaluated the impact of perioperative GLP-1RA use on both short-term (90-day) and long-term (1-year) postoperative complications in patients undergoing carpal tunnel release (CTR).

Methods: A retrospective cohort analysis was conducted with the TriNetX research database and identified all patients who underwent CTR at 95 health care organizations between 2004 and 2024. Two cohorts were stratified by perioperative GLP-1RA use and propensity score matched (1:1) to mitigate baseline differences in demographics, comorbidities, and procedural approach. Primary outcomes, including scarring, wound dehiscence, and infection, were evaluated over a 90-day postoperative period, whereas secondary outcomes, including subsequent CTR and median nerve (MN) injury, were assessed at the 1-year follow-up. Cohorts were compared using odds ratios (OR) with 95% confidence intervals (CI).

Results: The query identified 303,360 patients who underwent CTR, including 13,439 on perioperative GLP-1RA therapy. After matching, homogeneous cohorts each consisted of 10,773 patients. At 90 days after surgery, the GLP-1RA cohort had significantly lower odds of wound dehiscence (OR, 0.691; 95% CI, 0.488-0.978) compared with patients not on GLP-1RA therapy. No significant differences were observed in rates of infection (superficial, deep, or unspecified), abscess incision and drainage, or scarring. At 1 year, GLP-1RA patients had lower odds of subsequent CTR (OR, 0.897; 95% CI, 0.839-0.959) and MN injury (OR, 0.399; 95% CI, 0.192-0.832).

Conclusions: Perioperative GLP-1RA use was associated with a small yet statistically significant reduction in the odds of wound dehiscence following CTR and did not increase the odds of any other 90-day postoperative complications. Additionally, GLP-1RA therapy demonstrated lower odds of subsequent CTR and MN injury at the 1-year follow-up. Prospective investigation is warranted to further clarify the impact of GLP-1RA therapy in patients undergoing CTR.

Type of study/level of evidence: Prognostic III.

Keywords: Carpal tunnel release; Diabetes mellitus; Glucagon-like peptide-1 receptor agonists; Wound healing.

© 2025 The Authors.

目的： 由于其在血糖控制和体重减轻方面的有效性，胰高糖素样肽-1受体激动剂（GLP-1RA）的使用持续增加。关于GLP-1RA治疗对手术结果的影响的数据很少。鉴于糖尿病患者、肥胖者或两者兼有的腕管综合征患病率较高，本研究评估了围手术期使用GLP-1RA对接受腕管切开术（CTR）患者的短期（90天）和长期（一年）术后并发症的影响。

方法： 通过TriNetX研究数据库进行回顾性队列分析，识别了2004年至2024年间在95家医疗机构接受腕管切开术的所有患者。根据围手术期GLP-1RA的使用情况将两组分层，并通过倾向评分匹配（1:1）以减轻基线人口统计学、合并症和程序方法方面的差异。主要结果包括瘢痕形成、伤口裂开和感染，这些均在术后90天内进行评估，而次要结果包括后续腕管切开术和正中神经损伤，则在一年后随访时进行评估。使用优势比（OR）及95%置信区间（CI）比较各组。

结果： 查询结果显示303,360名接受腕管切开术的患者中，有13,439人接受了围手术期GLP-1RA治疗。匹配后，每个同质队列均包含10,773名患者。术后90天时，GLP-1RA组伤口裂开的风险显著低于未使用GLP-1RA的患者（OR，0.691；95% CI，0.488-0.978）。感染率（浅表、深层或未指明）、脓肿切开引流及瘢痕形成没有观察到显著差异。一年后，GLP-1RA组后续腕管切开术和正中神经损伤的风险更低（OR分别为0.897；95% CI, 0.839-0.959 和 OR为0.399; 95% CI, 0.192-0.832）。

结论： 围手术期使用GLP-1RA与腕管切开术后伤口裂开的风险小幅但具有统计学意义的降低相关，并且不增加任何其他短期（90天内）术后并发症的发生几率。此外，一年后随访发现GLP-1RA治疗显示出后续腕管切开术和正中神经损伤发生率更低的趋势。需要进行前瞻性研究进一步明确GLP-1RA治疗对接受腕管切开术患者的影响。

研究类型/证据级别： 预后III类。

关键词： 腕管松解；糖尿病；胰高糖素样肽-1受体激动剂；伤口愈合。

© 2025 The Authors.