Efficacy of mitomycin C in endoscopic dacryocystorhinostomy: a systematic review and meta-analysis.

<h4>Background</h4>A number of published comparative studies have been conducted to evaluate the efficacy and safety of intraoperative mitomycin C (MMC) in endoscopic dacryocystorhinostomy (EN-DCR). However, results have not always been consistent. Therefore, we carried out a meta-analys...

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Main Authors: Shi-ming Cheng, Yi-fan Feng, Ling Xu, Yan Li, Jin-hai Huang
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2013-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0062737
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author Shi-ming Cheng
Yi-fan Feng
Ling Xu
Yan Li
Jin-hai Huang
author_facet Shi-ming Cheng
Yi-fan Feng
Ling Xu
Yan Li
Jin-hai Huang
author_sort Shi-ming Cheng
collection DOAJ
description <h4>Background</h4>A number of published comparative studies have been conducted to evaluate the efficacy and safety of intraoperative mitomycin C (MMC) in endoscopic dacryocystorhinostomy (EN-DCR). However, results have not always been consistent. Therefore, we carried out a meta-analysis to compare the clinical results of EN-DCR with and without MMC.<h4>Methods and findings</h4>A comprehensive literature search of Cochrane Library, PubMed and EMBASE to identify relevant trials comparing EN-DCR with and without MMC. Eleven studies including 574 eyes were included in this meta-analysis. The success was defined as patency of the nasolacrimal canal and symptomatic improvement. There was significantly higher success rate in the MMC group in comparison with control group [RR = 1.12, 95% CI (1.04, 1.20), P = 0.004]. A sensitivity analysis after the non-randomized controlled trials were excluded from the meta-analysis demonstrated no differences compared with the overall results. Subgroup analyses showed that MMC group had a significantly higher success rate than control group in primary and revision EN-DCR, and EN-DCR without silicone intubation, but no difference in the subgroup of with silicone intubation. The size of the osteotomy site was bigger in the MMC group compared to the control group at 3 months [WMD = 7.65, 95% CI (0.33, 14.98), P = 0.041] and 6 months [WMD = 9.28, 95% CI (2.45, 16.11), P = 0.008] after surgery. However, there was statistically significant difference in the osteotomy surface area between the two groups at 12 months after surgery [WMD = 11.63, 95% CI (-1.04, 24.29), P = 0.072].<h4>Conclusion</h4>Intraoperative MMC application seems to be a safe adjuvant that could reduce the closure rate of the osteotomy and enhance the success rate after both primary and revision EN-DCR.<h4>Trial registration</h4>ClinicalTrials.gov NCT01772277.
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spelling doaj-art-fe58cf240e85441c9dea9a4f7c45b85d2025-08-20T03:49:56ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0185e6273710.1371/journal.pone.0062737Efficacy of mitomycin C in endoscopic dacryocystorhinostomy: a systematic review and meta-analysis.Shi-ming ChengYi-fan FengLing XuYan LiJin-hai Huang<h4>Background</h4>A number of published comparative studies have been conducted to evaluate the efficacy and safety of intraoperative mitomycin C (MMC) in endoscopic dacryocystorhinostomy (EN-DCR). However, results have not always been consistent. Therefore, we carried out a meta-analysis to compare the clinical results of EN-DCR with and without MMC.<h4>Methods and findings</h4>A comprehensive literature search of Cochrane Library, PubMed and EMBASE to identify relevant trials comparing EN-DCR with and without MMC. Eleven studies including 574 eyes were included in this meta-analysis. The success was defined as patency of the nasolacrimal canal and symptomatic improvement. There was significantly higher success rate in the MMC group in comparison with control group [RR = 1.12, 95% CI (1.04, 1.20), P = 0.004]. A sensitivity analysis after the non-randomized controlled trials were excluded from the meta-analysis demonstrated no differences compared with the overall results. Subgroup analyses showed that MMC group had a significantly higher success rate than control group in primary and revision EN-DCR, and EN-DCR without silicone intubation, but no difference in the subgroup of with silicone intubation. The size of the osteotomy site was bigger in the MMC group compared to the control group at 3 months [WMD = 7.65, 95% CI (0.33, 14.98), P = 0.041] and 6 months [WMD = 9.28, 95% CI (2.45, 16.11), P = 0.008] after surgery. However, there was statistically significant difference in the osteotomy surface area between the two groups at 12 months after surgery [WMD = 11.63, 95% CI (-1.04, 24.29), P = 0.072].<h4>Conclusion</h4>Intraoperative MMC application seems to be a safe adjuvant that could reduce the closure rate of the osteotomy and enhance the success rate after both primary and revision EN-DCR.<h4>Trial registration</h4>ClinicalTrials.gov NCT01772277.https://doi.org/10.1371/journal.pone.0062737
spellingShingle Shi-ming Cheng
Yi-fan Feng
Ling Xu
Yan Li
Jin-hai Huang
Efficacy of mitomycin C in endoscopic dacryocystorhinostomy: a systematic review and meta-analysis.
PLoS ONE
title Efficacy of mitomycin C in endoscopic dacryocystorhinostomy: a systematic review and meta-analysis.
title_full Efficacy of mitomycin C in endoscopic dacryocystorhinostomy: a systematic review and meta-analysis.
title_fullStr Efficacy of mitomycin C in endoscopic dacryocystorhinostomy: a systematic review and meta-analysis.
title_full_unstemmed Efficacy of mitomycin C in endoscopic dacryocystorhinostomy: a systematic review and meta-analysis.
title_short Efficacy of mitomycin C in endoscopic dacryocystorhinostomy: a systematic review and meta-analysis.
title_sort efficacy of mitomycin c in endoscopic dacryocystorhinostomy a systematic review and meta analysis
url https://doi.org/10.1371/journal.pone.0062737
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