The Annals of thoracic surgery · 2011
Meta-analysis of therapeutic procedures for acquired subglottic stenosis in adults.
СтатьяМетаанализНазвание и аннотация: Перевод в очереди
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Yamamoto Kazumichi, Kojima Fumitsugu, Tomiyama Ken-ichi, Nakamura Tatsuo, Hayashino Yasuaki
Аннотация
BACKGROUND: Treatment for adult subglottic stenosis is technically demanding and no therapeutic algorithm exists. We performed the present meta-analysis of treatment for this condition in an attempt to compare efficacy on the basis of type of procedure.
METHODS: We identified 24 eligible retrospective studies reporting the therapeutic results for inclusion criteria. Meta-analysis was performed by combining the results of the reported success rates; success is defined as a condition requiring no further treatment. The relative risk was used as a summary statistic.
RESULTS: Pooled success rates of laryngotracheal resection and anastomosis (12 articles) and laryngoplasty with or without grafting (7 articles) were 95% and 76%, respectively, using a random-effects model. Success rates of endoscopic dilatation and laser resection (6 articles) varied between 40% and 82%. Meta-regression analysis showed a significant difference in the success rates between laryngotracheal reconstruction and laryngoplasty and between laryngotracheal reconstruction and an endoscopic procedure. When the indication for endoscopic management was a lesion size less than 1 cm, the results were significantly better.
CONCLUSIONS: The success rate of laryngotracheal reconstruction is significantly higher than that of laryngoplasty or endoscopic intervention; however, endoscopic intervention is worth trying for lesions smaller than 1 cm without framework destruction.
METHODS: We identified 24 eligible retrospective studies reporting the therapeutic results for inclusion criteria. Meta-analysis was performed by combining the results of the reported success rates; success is defined as a condition requiring no further treatment. The relative risk was used as a summary statistic.
RESULTS: Pooled success rates of laryngotracheal resection and anastomosis (12 articles) and laryngoplasty with or without grafting (7 articles) were 95% and 76%, respectively, using a random-effects model. Success rates of endoscopic dilatation and laser resection (6 articles) varied between 40% and 82%. Meta-regression analysis showed a significant difference in the success rates between laryngotracheal reconstruction and laryngoplasty and between laryngotracheal reconstruction and an endoscopic procedure. When the indication for endoscopic management was a lesion size less than 1 cm, the results were significantly better.
CONCLUSIONS: The success rate of laryngotracheal reconstruction is significantly higher than that of laryngoplasty or endoscopic intervention; however, endoscopic intervention is worth trying for lesions smaller than 1 cm without framework destruction.