To analyze the efficacy and safety of peripheral nerve decompression in patients with P-DPN by literature meta-analysis.

A meta-analysis was conducted to compare the efficacy of painful diabetic peripheral neuropathy surgery and conservative treatment by searching comprehensive literature search platforms at home and abroad.

A total of 679 literatures were retrieved, and 6 literatures were included. A total of 729 patients with P-DPN were enrolled in the study. There were statistically significant differences in sural nerve conduction velocity (NCV), total peroneal NCV and superficial peroneal NCV (P<0.00001), and NCV was significantly improved in the surgery group. Tibial NCV was no statistically different in the two literatures (P=0.67), considering the fewer included literatures, bias is required for further verification. There were statistically significant differences in the thresholds of vibration sensation and cold and heat sensation (P<0.00001), indicating significant improvement in vibration sensation and cold and heat sensation after surgery.

The results of our study indicate that peripheral nerve decompression can significantly improve nerve conduction velocity and nerve function in patients with P-DPN. Because there are few high-quality randomized controlled trials or well-designed prospective studies, more data are needed to elucidate the role of surgery in the future treatment of P-DPN.