Traditional endonasal and microscopic sinus surgery complications versus endoscopic sinus surgery complications: a meta-analysis
Por:
Re, M, Massegur, H, Magliulo, G, Ferrante, L, Sciarretta, V, Farneti, G, Macri, G, Mallardi, V, Pasquini, E
Publicada:
1 mar 2012
Resumen:
The aim of this study was to compare the incidence of complications of endoscopic sinus surgery (ESS) to the incidence of complications of traditional and microscopic sinus surgery. A meta-analysis was carried out on 28 series of patients (a total of 13,405) who had undergone ESS, 8 series of patients (3,887 in total) who had undergone traditional endonasal sinus surgery and 7 series of patients (1,630 in total) who had undergone microscopic sinus surgery. The authors used the Bayesian inference package WinBUGS operating from within the statistical computer program R (version 2.7.1). Major complications had a higher incidence after traditional sinus surgery than ESS but this fact did not cause a significant statistical difference, whereas microscopic surgery had significantly more complications than ESS (p < 0.05). Carrying out our meta-analytic study, comparing major and minor complications of endonasal surgical approaches, was very difficult due to several methodological biases of data extraction and evaluation from studies concerning a broad timespan. Regarding major complications, we only found a significant statistical difference (p < 0.05) between the endoscopic (1%) and the microscopic methods (2.0%), but, if we had analyzed the data considering the natural learning curve of the latest ESS surgical approach, and if we had not considered the results produced in the first 10 years (1988-1998) concerning ESS in our meta-analysis, we would have found a statistically significant difference (p < 0.05) between the endoscopic (0.4%) and the traditional (1.1%) approach as well.
Filiaciones:
Re, M:
Polytech Univ Marche, Dept Otorhinolaryngol, I-60126 Ancona, Italy
Massegur, H:
St Pau Hosp, ENT Dept, Barcelona, Spain
Magliulo, G:
Univ Roma La Sapienza, Dept Otorhinolaryngol, Rome, Italy
Ferrante, L:
Polytech Univ Marche, Dept Clin Med & Appl Biotechnol, I-60126 Ancona, Italy
Sciarretta, V:
Univ Bologna, ENT Dept, St Orsola Malpighi Hosp, Bologna, Italy
Farneti, G:
Univ Bologna, ENT Dept, St Orsola Malpighi Hosp, Bologna, Italy
Macri, G:
Univ Bologna, ENT Dept, St Orsola Malpighi Hosp, Bologna, Italy
Mallardi, V:
Polytech Univ Marche, Dept Otorhinolaryngol, I-60126 Ancona, Italy
Pasquini, E:
Univ Bologna, ENT Dept, St Orsola Malpighi Hosp, Bologna, Italy
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