Anijeet Deepa, Dolan Lynne, Macewen Caroline J
St Paul's Eye Unit, Royal Liverpool and Broadgreen University Hospital, Liverpool, UK, L7 8XP.
Cochrane Database Syst Rev. 2011 Jan 19(1):CD007097. doi: 10.1002/14651858.CD007097.pub2.
Dacryocystorhinostomy (DCR) procedures can be performed using external or endonasal approaches. The comparative success rates of these procedures are unknown.
To compare the success rates of external and endonasal approaches to DCR.
We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2010, Issue 11), MEDLINE (January 1950 to December 2010), EMBASE (January 1980 to December 2010), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to December 2010), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com) (December 2010), ClinicalTrials.gov (www.clinicaltrials.gov) (December 2010) and Web of Science Conference Proceedings Citation Index- Science (CPCI-S) (January 1990 to December 2010). There were no language or date restrictions in the search for trials. The electronic databases were last searched on 7 December 2010. We requested or examined relevant conference proceedings for appropriate trials.
We included all randomised controlled trials (RCTs) comparing external and endonasal dacryocystorhinostomies.
Two review authors independently performed data extraction and assessment of quality with a predefined form. We contacted investigators to clarify the methodological quality of the studies.
We identified one trial that fulfilled the inclusion criteria. This trial compared 64 DCR procedures (32 external and 32 endonasal procedures). Endonasal DCR was four times more likely to fail compared to external DCR. This was statistically significant (95% confidence interval (CI) 1.25 to 12.84).
AUTHORS' CONCLUSIONS: The only trial included in the review provides evidence that endonasal DCR has statistically higher risk of failure compared to external DCR. However, this conclusion is limited by paucity of RCTs, small number of participants and lack of clarity of the methodological process. Well conducted RCTs with sufficient power are required to answer the research question.
泪囊鼻腔吻合术（DCR）可通过外部或鼻内入路进行。这些手术的比较成功率尚不清楚。
比较DCR外部和鼻内入路的成功率。
我们检索了Cochrane系统评价数据库（CENTRAL）（其中包含Cochrane眼科和视力组试验注册库）（《Cochrane图书馆》2010年第11期）、医学期刊数据库（MEDLINE）（1950年1月至2010年12月）、荷兰医学文摘数据库（EMBASE）（1980年1月至2010年12月）、拉丁美洲和加勒比地区卫生科学文献数据库（LILACS）（1982年1月至2010年12月）、对照试验元注册库（mRCT）（www.controlled-trials.com）（2010年12月）、美国国立医学图书馆临床试验数据库（ClinicalTrials.gov）（www.clinicaltrials.gov）（2010年12月）以及科学网会议论文被引频次索引数据库（Web of Science Conference Proceedings Citation Index - Science，CPCI - S）（1990年1月至2010年12月）。检索试验时没有语言或日期限制。电子数据库最后一次检索时间为2010年1月7日。我们索取或查阅了相关会议论文以寻找合适的试验。
我们纳入了所有比较外部和鼻内泪囊鼻腔吻合术的随机对照试验（RCT）。
两位综述作者使用预定义表格独立进行数据提取和质量评估。我们联系了研究者以澄清研究的方法学质量。
我们确定了一项符合纳入标准的试验。该试验比较了64例泪囊鼻腔吻合术（32例外部手术和32例鼻内手术）。与外部泪囊鼻腔吻合术相比，鼻内泪囊鼻腔吻合术失败的可能性高四倍。这具有统计学意义（95%置信区间（CI）为1.25至12.84）。
本综述中纳入的唯一一项试验提供的证据表明，与外部泪囊鼻腔吻合术相比，鼻内泪囊鼻腔吻合术在统计学上失败风险更高。然而，这一结论受到RCT数量少、参与者数量少以及方法学过程不清晰的限制。需要进行有足够效力的高质量RCT来回答该研究问题。
