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经唇下入路切除与经鼻内镜下造袋术治疗鼻唇囊肿的比较:一项系统评价和荟萃分析。

Sublabial excision versus transnasal endoscopic marsupialization for nasolabial cysts: A systematic review and meta-analysis.

机构信息

College of Medicine, Chang Gung University, Taoyuan, Taiwan.

Department of Otolaryngology - Head and Neck Surgery, Chang Gung Memorial Hospital, Keelung, Taiwan.

出版信息

Clin Otolaryngol. 2024 Jan;49(1):102-108. doi: 10.1111/coa.14105. Epub 2023 Oct 11.

Abstract

OBJECTIVES

To compare the intraoperative and postoperative outcomes of sublabial excision and transnasal endoscopic marsupialization, the two primary surgical approaches for nasolabial cysts.

DESIGN AND SETTING

A comprehensive meta-analysis of studies identified from PubMed, Embase, and the Cochrane Library.

PARTICIPANTS

Patients diagnosed with nasolabial cysts who underwent surgical treatment.

MAIN OUTCOME MEASURES

Operative time, postoperative pain, overall postoperative complications, admission rate, length of hospital stay, use of general anaesthesia, medical costs, and recurrence rate.

RESULTS

The pooled analysis revealed that the transnasal endoscopic marsupialization group had shorter operative time (mean differences [MD], -32.51; 95% confidence interval [CI], -38.52 to -26.51), reduced postoperative pain (MD, -4.25; 95% CI, -7.62 to -0.89), fewer overall postoperative complications (risk difference [RD], -0.68; 95% CI, -0.90 to -0.46), lower admission rates (RD, -0.86; 95% CI, -1.11 to -0.61), shorter hospital stays (MD, -1.74; 95% CI, -2.58 to -0.89), decreased use of general anaesthesia (RD, -0.40; 95% CI, -0.76 to -0.03), and reduced medical costs (MD, -229.69; 95% CI, -338.64 to -120.75). The recurrence rate between the two groups showed no significant difference (RD, -0.01; 95% CI, -0.05 to 0.04).

CONCLUSION

Transnasal endoscopic marsupialization presents as a promising alternative to sublabial excision in the treatment of nasolabial cysts. It offers advantages like reduced operative time, decreased postoperative pain, fewer complications, lower admission rates, shorter hospital stays, diminished need for general anaesthesia, and cost savings. Clinicians can leverage these findings to select the most suitable surgical approach for their patients.

摘要

目的

比较唇下切除和经鼻内镜造袋术这两种治疗鼻唇囊肿的主要手术方法的术中及术后结果。

设计和设置

对从 PubMed、Embase 和 Cochrane 图书馆中确定的研究进行全面的荟萃分析。

参与者

接受手术治疗的鼻唇囊肿患者。

主要观察指标

手术时间、术后疼痛、总术后并发症、住院率、住院时间、全身麻醉使用率、医疗费用和复发率。

结果

汇总分析显示,经鼻内镜造袋术组的手术时间更短(平均差异 [MD],-32.51;95%置信区间 [CI],-38.52 至-26.51),术后疼痛减轻(MD,-4.25;95% CI,-7.62 至-0.89),总术后并发症更少(风险差异 [RD],-0.68;95% CI,-0.90 至-0.46),住院率更低(RD,-0.86;95% CI,-1.11 至-0.61),住院时间更短(MD,-1.74;95% CI,-2.58 至-0.89),全身麻醉使用率降低(RD,-0.40;95% CI,-0.76 至-0.03),医疗费用减少(MD,-229.69;95% CI,-338.64 至-120.75)。两组间的复发率无显著差异(RD,-0.01;95% CI,-0.05 至 0.04)。

结论

经鼻内镜造袋术是治疗鼻唇囊肿的一种很有前途的替代唇下切除的方法。与唇下切除相比,它具有手术时间更短、术后疼痛减轻、并发症更少、住院率更低、住院时间更短、全身麻醉使用率降低、医疗费用节省等优点。临床医生可以利用这些发现为患者选择最合适的手术方法。

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