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Surgery is slightly better than non-surgical treatment for patients with carpal tunnel syndrome who don’t have severe nerve damage (denervation), new research has found.

The study included 44 patients who had surgery and 52 patients who had non-surgical treatment, such as hand therapy and ultrasound. A year after treatment, the patients’ hand function was measured using the Carpal Tunnel Syndrome Assessment Questionnaire (CTSAQ).

The patients who had surgery showed an advantage in both function and symptoms — calculated by proportions of patients having at least 30 percent improvement in CTSAQ scores for these indicators, and having minimal interference in daily work or household activities. The study found that 46 percent of surgery patients and 27 percent of non-surgery patients met all three criteria.

“Overall, these data indicate that, in patients with carpal tunnel syndrome without denervation, surgery modestly improves hand function and symptoms by three months compared with a multimodality non-surgical treatment regimen, and this benefit is sustained through one year,” wrote Dr. Jeffrey Jarvik, of Harborview Medical Center at the University of Washington in Seattle, and colleagues.

“However,” they continued, “some patients allocated to surgery reported persistent symptoms, and 61 percent of patients allocated to non-surgical treatment avoided surgery altogether. Our study, together with previous evidence, indicates that surgery is useful for patients with carpal tunnel syndrome.”

The study appears online Sept. 24 in a special surgery issue of The Lancet.

Patient treatment preference is an important factor, two Swedish doctors noted in an accompanying editorial. When patients are “faced with the need to wear a splint each night and during daytime for some weeks, some might prefer early surgery while others may prefer partial recovery to potential surgical risk,” wrote Dr. Isam Atroshi and Christina Gummesson, both of Lund University.

“Nevertheless, patients with carpal tunnel syndrome who do not have satisfactory improvement with non-surgical treatment should be offered surgery,” the editorialists concluded.

Another study in the special surgery issue of The Lancet found that placing a drain in the skull after surgery reduces the risk of death and recurrence among patients with chronic subdural hematoma, in which blood collects under the dura, the outer protective membrane that covers the brain.

After surgery to drain the blood, between 5 percent and 30 percent of patients have recurrence of chronic subdural hematoma and require redrainage, Peter Hutchinson of Addenbrooke’s Hospital in Cambridge, U.K., and colleagues noted.

In the study, the researchers assessed 215 patients, aged 18 years and older, with a chronic subdural hematoma who were treated using the burr-hole surgery technique. Of those patients, 108 had a plastic drain inserted a few centimeters into the subdural space after surgery. The drain was left in for a few days.

Subdural hematoma recurred in 10 of 108 people (9.3 percent) with the drain and in 26 of 107 (24 percent) of patients without the drain. After six months, 8.6 percent of patients in the drain group and 18.1 of those in the non-drain group had died, the researchers reported.

A common, nonmalignant tumor of the breast called ductal carcinoma in-situ or DCIS may need a name change because the word “carcinoma” scares so many women, a U.S. panel of experts said on Thursday.

They said the term carcinoma creates a lot of worry in women who fear they will develop cancer, even though long-term survival rates for DCIS are excellent, approaching 100 percent. “We’ve had long discussions about this,” Dr. Susan Reed of the University of Washington School of Medicine told a briefing.

She was one of several independent panelists asked by the National Institutes of Health to look into whether too many women are being treated too aggressively for a condition that is poorly understood.

“If you use a word that evokes fear, as the word carcinoma may, I think we need to consider is that appropriate,” said Reed, who favors changing the name to something less scary.

DCIS is a condition in which abnormal cells accumulate in the breast duct, but have not spread to other tissues in the breast.

Since the start of widespread mammography screening in the 1980s, rates of DCIS diagnoses have increased sevenfold. By 2020, an estimated 1 million U.S. women will be living with a DCIS diagnosis.

And because most women diagnosed with DCIS get treated for it — with surgery to remove the cells and sometimes radiation — little is known about how much of a risk it presents, or whether some women might do well with less or no treatment.

“Despite having had a century of knowledge of the disease, we do not understand the natural history of DCIS, and probably never will,” Dr. Carmen Allegra of the University of Florida, who chaired the panel, told the briefing.

After two days of scientific presentations and many discussions, the panel is urging scientists to come up with better ways to determine which women with DCIS might develop invasive breast cancer.

“Given that this diagnosis has significant emotional impact for the women diagnosed with it, we felt it was critical to develop methods that would allow a very precise determination of exactly which patients would ultimately be at risk for developing invasive disease,” Allegra said.

And he said the medical community needs to at least consider whether the name of the condition, which raises the specter of cancer, may need to be changed.

Not all panel members think that is a good idea.

Dr. Arnold Schwartz, a surgical pathologist at George Washington University Hospital, said the cells that eventually replace the duct are identical to the cells in invasive cancer, suggesting that DCIS is a precursor to cancer.

“We have many other cancers in the body and precursor cancers that are also called carcinoma in-situ. Cancers of the skin, head and neck, esophagus and bladder also have the term carcinoma without any emotional impact,” he said.

More than 400,000 women in the world die from breast cancer each year.