Background:Ganglia are benign soft tissue tumors most commonly encountered in the wrist, but which may occur in any joint.Most patients present with a painless swelling, some with pain due to pressure on the posterior interosseous nerve and some for cosmetic reasons.Treating a ganglion cyst is a surgeon’s dilemma.But very few literature compares Excision vs Aspiration vs Setoning. Hence a study was undertaken to compare the outcomes of all the three treatment options.

Methods:108 patients who underwent treatment for ganglion wrist at command hospital, Pune from Jun 2016 to Jun 2017 were included in the study. All patients were explained about the natural history of disease and three procedures in detail.T he surgeon’s preference and patients choice dictated which of the three methods was used. The patients were followed on post op day 2, after 1 week, 3 months and after 6 months.

Results:A total number of 108 pts were recruited into the study out of which 68(62.96%) were females and 40(37.04%) were males.29 out of 36 in the aspiration group and 15 out of 20 in the setoning group were females.There is a statistical difference in the rate of infection between the three interventions(p–value 0.017, chi–square statistics – 8.09). Highest of 35% in the setoninggroup , 11.53% in the excision group and lowest of 8.33% in the aspiration group.The recurrence rates were as high as 52.77% in the aspiration group as compared to 15% in setoning and 13.46% in the excision group.

Conclusion:Treating a ganglion cyst is a surgeon’s dilemma. Providing the best care for patients is the prime aim. Our study suggest though Setoning provide a comparable recurrence rate but is associated with fairly high rate of infection. And Aspiration though has cosmetically favorable outcome with a low SSI rate but has a significantly high recurrence rate. Thus Surgical excision is the best possible solution with the least complication rates.