Scholarlink

Purpose <p>To evaluate whether stent placement improves the surgical success of dacryocystorhinostomy (DCR), considering different approaches and stenting durations.</p> Methods <p>We conducted a systematic search of PubMed, Embase, Cochrane Library, and Web of Science for randomized controlled trials (RCTs) comparing DCR with and without stent insertion. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using the Mantel-Haenszel (MH) fixed-effect model, as heterogeneity was negligible (I²&lt;0.1%). Subgroup analyses were conducted to compare surgical approach (external, endoscopic, and laser-assisted) and stenting duration (≤ 6 weeks vs. &gt;6 weeks). Heterogeneity was assessed using Cochran’s Q and I² statistics. Sensitivity analysis and publication bias were also evaluated.</p> Results <p>Eighteen RCTs involving 1,517 patients were included. The meta-analysis demonstrated that stent placement significantly improved the DCR success rate compared to non-stented DCR (OR = 1.691; 95% CI: 1.196–2.391; <i>p</i> = 0.003). The average success rates were 92.6% and 88.2% in the stented and non-stented groups, respectively. Subgroup analysis showed significantly better outcomes in external DCR with stenting but not in endoscopic DCR. A shorter stenting duration (≤ 6 weeks) also showed significant benefit over non-stented procedures, whereas longer duration (&gt; 6 weeks) did not. Heterogeneity was low (I²&lt;0.1%), and sensitivity analysis confirmed the robustness of the findings.</p> Conclusions <p>Stented DCR significantly enhanced surgical success in external approaches, while internal approaches lack significant difference and evidence for laser-assisted DCR remains limited. Also, a shorter stenting duration appears to be associated with a higher success rate while potentially minimizing complications according to prior evidence, although the optimal duration remains uncertain. Further research is needed to clarify the efficacy of stenting in laser-assisted DCR.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Outcomes of dacryocystorhinostomy with or without stent Insertion-A systematic review and Meta-analysis

  • 期刊论文

  • 发表日期：

    2025年11月11日

查看全文
  • Tzu-Tang Lin,
  • Chih-Hao Liu,
  • Yu-Ming Hsu,
  • Yong-Yuan Chang,
  • Te-Yu Chen,
  • Yu-Fen Huang,
  • Pin-Rong Chen,
  • Chih-Hsing Hung,
  • Da-Wei Wu

摘要

Purpose

To evaluate whether stent placement improves the surgical success of dacryocystorhinostomy (DCR), considering different approaches and stenting durations.

Methods

We conducted a systematic search of PubMed, Embase, Cochrane Library, and Web of Science for randomized controlled trials (RCTs) comparing DCR with and without stent insertion. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using the Mantel-Haenszel (MH) fixed-effect model, as heterogeneity was negligible (I²<0.1%). Subgroup analyses were conducted to compare surgical approach (external, endoscopic, and laser-assisted) and stenting duration (≤ 6 weeks vs. >6 weeks). Heterogeneity was assessed using Cochran’s Q and I² statistics. Sensitivity analysis and publication bias were also evaluated.

Results

Eighteen RCTs involving 1,517 patients were included. The meta-analysis demonstrated that stent placement significantly improved the DCR success rate compared to non-stented DCR (OR = 1.691; 95% CI: 1.196–2.391; p = 0.003). The average success rates were 92.6% and 88.2% in the stented and non-stented groups, respectively. Subgroup analysis showed significantly better outcomes in external DCR with stenting but not in endoscopic DCR. A shorter stenting duration (≤ 6 weeks) also showed significant benefit over non-stented procedures, whereas longer duration (> 6 weeks) did not. Heterogeneity was low (I²<0.1%), and sensitivity analysis confirmed the robustness of the findings.

Conclusions

Stented DCR significantly enhanced surgical success in external approaches, while internal approaches lack significant difference and evidence for laser-assisted DCR remains limited. Also, a shorter stenting duration appears to be associated with a higher success rate while potentially minimizing complications according to prior evidence, although the optimal duration remains uncertain. Further research is needed to clarify the efficacy of stenting in laser-assisted DCR.