Endoscopic assisted adenoidectomy versus conventional curettage adenoidectomy: a meta-analysis of randomized controlled trials

Abstract

Adenoidectomy, surgical removal of hypertrophic adenoids, is a common operation in children worldwide. The purpose of this study was to compare the operative effectiveness, and included total operative time, blood loss and complications, between endoscopic assisted adenoidectomy and conventional curettage adenoidectomy. EMBASE, PubMed, Cochrane Library, and China National Knowledge Infrastructure and symposiums and review articles were used to choose relevant randomized controlled trials. A meta-analysis was performed to analyze the data for total operative time, blood loss and complications. Seven studies fit the inclusion criteria, and included 331 patients treated with endoscopic assisted adenoidectomy, and 251 patients treated with conventional curettage adenoidectomy. The meta-analysis demonstrated that compared with conventional curettage adenoidectomy, endoscopic assisted adenoidectomy had a shorter operative time (SMD -1.09; 95 % CI -1.29 to -0.90; p < 0.00001), less blood loss (MD -19.74; 95 % CI -22.75 to -16.73; p < 0.00001), and fewer complications (OR 0.15; 95 % CI 0.07-0.35; p < 0.0001). Endoscopic assisted adenoidectomy has advantages over conventional curettage adenoidectomy with regard to total operative time, blood loss and complications.

Keywords: Blood loss; Complications; Curettage; Endoscopy; Meta-analysis; Operative time.

Fig. 1

The flow diagram of included studies

Fig. 2

Risk of bias of included studies. Represents low risk represents high risk blank space of risk bias represents unclear risk

Fig. 3

Forest plots of standard mean difference (SMD) and 95 % confidence interval (CI) for total operative time

Fig. 4

Forest plots of standard mean difference (SMD) and 95 % confidence interval (CI) for blood loss

Fig. 5

Forest plots of odds ratio (OR) and 95 % confidence interval (CI) for complications