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慢性泪囊炎患者行内镜下泪囊鼻腔造口术置入与未置入普理灵支架的手术结果:一项随机对照试验

Surgical Outcome of Endoscopic Dacryocystorhinostomy with and Without Prolene Stent in Chronic Dacryocystitis: A Randomized Controlled Trial.

作者信息

Deosthale Nitin, Garikapati Pavani, Choudhary Samir, Khadakkar Sonali, Deshpande Anusha, Mangade Sajeevani, Dhote Kanchan

机构信息

Department of ENT, NKPSIMS and RC, Digdoh Hills, Hingna Road, Nagpur, 440024 India.

Department of ENT, DMMC, Nagpur, India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2023 Dec;75(4):3443-3448. doi: 10.1007/s12070-023-03911-1. Epub 2023 Jun 27.

Abstract

Popularity of Endoscopic dacryocystorhinostomy is rising over a conventional external dacryocystorhinostomy. One of the most frequent reasons for procedure failure is the closing of neo-ostium. To compare the surgical results of endoscopic Dacryocystitis operations with and without Prolene stents in terms of procedure success rates and postoperative complications. A randomized controlled trial of 2 years was carried out including 100 patients of chronic dacryocystitis. The cases were randomly split into two groups with 50 cases each in Endoscopic DCR with stent and without stent groups. The results, both the subjective and objective were noted. At the end of 3 months, the overall success rate was 88% and 90% in group with and without stent respectively with no significant statistical difference. 12% subjects had wound infection, 8% had granulations around the rhinostoma, 6% had synechiae, 10% had discomfort from the tube in stent group. In Group B (without stent), 16% had wound infection, 4% had granulations around the rhinostoma. As Endoscopic DCR without stent has equally good results and less complications as compared to with stent, we recommend endoscopic DCR without stent. Use of Stent should be reserved for special conditions like revision cases, common canalicular block, fibrosed lacrimal sac.

摘要

与传统的外路泪囊鼻腔吻合术相比,内镜下泪囊鼻腔吻合术越来越受欢迎。手术失败最常见的原因之一是新造口闭合。为了比较在内镜下泪囊炎手术中使用和不使用普理灵支架在手术成功率和术后并发症方面的手术结果。进行了一项为期2年的随机对照试验,纳入100例慢性泪囊炎患者。将病例随机分为两组,内镜下泪囊鼻腔吻合术带支架组和不带支架组各50例。记录主观和客观结果。在3个月末,带支架组和不带支架组的总体成功率分别为88%和90%,无显著统计学差异。支架组12%的受试者有伤口感染,8%的受试者在造口周围有肉芽组织,6%的受试者有粘连,10%的受试者因支架中的管子感到不适。在B组(不带支架)中,16%的受试者有伤口感染,4%的受试者在造口周围有肉芽组织。由于与带支架的内镜下泪囊鼻腔吻合术相比,不带支架的内镜下泪囊鼻腔吻合术有同样好的效果且并发症更少,我们推荐不带支架的内镜下泪囊鼻腔吻合术。支架的使用应保留用于特殊情况,如翻修病例、泪小管共同阻塞、泪囊纤维化。

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