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Meta-Analysis
. 2017 May 16;7(1):1936.
doi: 10.1038/s41598-017-02070-y.

Comparing the Success Rate of Dacryocystorhinostomy With and Without Silicone Intubation: A Trial Sequential Analysis of Randomized Control Trials

ChuanQi Xie  1 , Lingling Zhang  2 , Yang Liu  3 , Hong Ma  3 , Shuzhen Li  3
Affiliations
Meta-Analysis

Comparing the Success Rate of Dacryocystorhinostomy With and Without Silicone Intubation: A Trial Sequential Analysis of Randomized Control Trials

ChuanQi Xie et al. Sci Rep. .

Erratum in

Abstract

A previous meta-analysis reported no benefit for silicone intubation during dacryocystorhinostomy. However, the power of this meta-analysis was 0.274. Therefore, the benefit of silicone intubation remains controversial. We undertook a cumulative meta-analysis to evaluate the success rate of dacryocystorhinostomy (DCR) with and without the use of a stent. Pubmed, EMBASE and the Cochrane Library were searched. Statistical power and trial sequential analyses were performed according to the result of the meta-analysis. Twelve randomized controlled trials involving 969 cases met the inclusion criteria. The success rates of DCR with and without intubation were significantly different (p = 0.006). The success rates of external DCR (EX-DCR) with and without intubation were also significantly different based on subgroup analysis (p = 0.002). The cumulative z-curves crossed the O'Brian-Fleming boundaries. There were no significant differences in the success rate in the endonasal endoscopic DCR (EN-DCR) subgroup or the occurrence of postoperative complications between the two groups based on the meta-analysis, and the z-curve did not intersect any trial sequential analysis boundaries. DCR with intubation achieved better results than DCR without intubation, especially in the EX-DCR subgroup. Differences in the success rate in the EN-DCR subgroup and postoperative complications between the two groups were underpowered to reach a conclusion.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Study flow diagram, .
Figure 2
Figure 2
Risk of bias summary: the review authors’ judgements about each risk of bias item for each included study.
Figure 3
Figure 3
Forest plot: comparison of success rate between DCR with and without silicone intubation.
Figure 4
Figure 4
Forest plot: subgroup analysis of the success rate between DCR with and without silicone intubation.
Figure 5
Figure 5
Postoperative complication (granulation) of dacryocystorhinostomy with or without silicone intubation.
Figure 6
Figure 6
Postoperative complication (infection) of dacryocystorhinostomy with or without silicone intubation.
Figure 7
Figure 7
Postoperative complication (adhesion) of dacryocystorhinostomy with or without silicone intubation.
Figure 8
Figure 8
Forest plot of the cumulative meta-analysis.
Figure 9
Figure 9
Trial sequential analysis of 12 included studies.
Figure 10
Figure 10
Trial sequential analysis of the EX-DCR subgroup.
Figure 11
Figure 11
Trial sequential analysis of the EN-DCR subgroup.
Figure 12
Figure 12
Funnel plot of publication bias.
See this image and copyright information in PMC

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