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内镜下泪囊鼻腔造口术——三级医疗中心动力与非动力器械技术的比较结果

Endoscopic Dacryocystorhinostomy - Comparative Outcomes of Powered vs. Non - Powered Instrument Techniques in a Tertiary Care Hospital.

作者信息

Chaitanya Nelluri, Pal Indranil, Usha G, Kumar Saumitra, Mondal Bibhas

机构信息

West Bengal University of Health Sciences College of Medicine and JNM Hospital, Kalyani, West Bengal 741235 India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2025 Jan;77(1):49-56. doi: 10.1007/s12070-024-05104-w. Epub 2024 Nov 7.

Abstract

This study compares the outcomes and complications associated with Powered and Non - Powered instrument techniques in patients undergoing Endoscopic Dacryocystorhinostomy (Endo DCR). An Observational, longitudinal study was carried out on 146 cases of Chronic Dacryocystitis who were divided into two equal groups. One group underwent Endo DCR by powered instruments (Powered group - PG) and the other group by non-powered technique (Non Powered group - NPG). Operating time was taken from incision to tucking of flaps of the lacrimal sac mucosa. Postoperative assessment was done on 7th, 30th and 180th day of surgery. Subjective assessment was based on relief from epiphora while objective on lacrimal sac syringing (LSS) and Diagnostic nasal endoscopic (DNE) findings. Both the groups were compared for the success rate and complications. Out of 146 cases operated, 6 cases were cancelled due to intraoperative bleeding. 109 Endo DCR were done on right side while 31 cases were operated on left side. The mean operating time in NPG is 48.74 min and in PG is 64.91 min with p=<0.001 which is highly significant. Postoperative success rate among PG and NPG is 88.2% and 84.7% (p=0.829) while complications for both the groups were statistically not significant (p=0.701). Non-powered technique showed significant reduction in operating time compared to powered drill for Endo DCR. No significant difference was found between the powered and the non-powered groups in terms of success rate and complications surgery, Head of the Dept, Sri Devaraj Urs Academy of Higher Education and Research Medical College azeem_hn@yahoo.co.in Vast clinical knowledge, Surgical skills, with a passion in research, great teacher, motivator for junior colleagues and students, dedicated surgeon for service to mankind.

摘要

本研究比较了接受内镜下泪囊鼻腔造口术(Endo DCR)的患者使用动力器械和非动力器械技术的手术效果及并发症。对146例慢性泪囊炎患者进行了一项观察性纵向研究,将其平均分为两组。一组采用动力器械进行Endo DCR(动力组 - PG),另一组采用非动力技术(非动力组 - NPG)。手术时间从泪囊黏膜瓣切开至缝合计算。术后分别在手术第7天、30天和180天进行评估。主观评估基于溢泪症状缓解情况,客观评估基于泪囊冲洗(LSS)和诊断性鼻内镜(DNE)检查结果。比较两组的成功率和并发症情况。在146例手术患者中,6例因术中出血取消手术。109例Endo DCR手术在右侧进行,31例在左侧进行。NPG组的平均手术时间为48.74分钟,PG组为64.91分钟,p = <0.001,具有高度显著性差异。PG组和NPG组的术后成功率分别为88.2%和84.7%(p = 0.829),两组并发症在统计学上无显著差异(p = 0.701)。与动力钻相比,非动力技术在Endo DCR手术中手术时间显著缩短。动力组和非动力组在手术成功率和并发症方面未发现显著差异,斯里德瓦拉杰·乌尔高等教育与研究学院医学院系主任azeem_hn@yahoo.co.in 拥有丰富的临床知识、手术技能,热衷于研究,是优秀的教师、初级同事和学生的激励者,是致力于为人类服务的外科医生。

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本文引用的文献

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Dacryocystorhinostomy: Evolution of endoscopic techniques after 498 cases.泪囊鼻腔造口术:498例手术后内镜技术的发展
Eur J Ophthalmol. 2020 Sep;30(5):998-1003. doi: 10.1177/1120672119854582. Epub 2019 Jun 10.
4
The use of an ostial stent does not increase the success rate of endoscopic dacryocystorhinostomy.
J Laryngol Otol. 2018 Aug;132(8):718-723. doi: 10.1017/S002221511800107X. Epub 2018 Jul 12.

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