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Safety of Different Surgical Modalities for Recurrent Respiratory Papillomatosis Resection: A Systematic Review and Meta-Analysis
  • SiWei Liu,
  • Jiaqi Wang,
  • Jun Shao
SiWei Liu
Fudan University

Corresponding Author:[email protected]

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Jiaqi Wang
Fudan University Eye Ear Nose and Throat Hospital
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Jun Shao
Fudan University Eye Ear Nose and Throat Hospital
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Abstract

Abstract Background: Currently, the most common surgical modalities used for recurrent respiratory papillomatosis resection are microdebrider, CO2 laser, and KTP laser. However, complication rates vary among different surgical modalities and have been controversial in different studies. Objective of review: This study systematically reviews the available studies which reported intraoperative and postoperative complications, aiming to compare the safety of microdebrider, CO2 laser, and KTP laser. Type of review: Meta-analysis. Search strategy: Seven electronic databases (PubMed/MEDLINE, EMBASE[Ovid], Scopus, Cochrane Library, and Web of Science) were searched from inception through April 28th,2022. Randomized controlled, prospective or retrospective observational studies that recorded the complications of three different surgical modalities for recurrent respiratory papillomatosis resection were included in the meta-analysis. Evaluation method: Outcomes of interest were intraoperative and postoperative complications, and complication rate was calculated to evaluate the safety of surgical methods. Results: Twenty different studies was included in quantitative synthesis. Only one study compared outcomes of those three kinds of treatment modalities simultaneously, two studies compared microdebrider and CO2 laser, and the remaining studies focused on only one of three treatments. The weighted average complication rate for microdebrider was 0.03(95% confidence interval [CI] 0.00-0.21), n = 6, for CO2 laser treatment was 0.16 (95% confidence interval [CI] 0.09-0.25), n = 14,and for KTP laser treatment was 0.04 (95% CI 0.00-0.14), n =4. Conclusion:The limited evidence demonstrated that CO2 lasers in the surgical treatment of RRP may lead to more surgical complications, and microdebrider and KTP lasers may be safer. However, the heterogeneous data limits any strong comparison of outcomes of different treatment of laryngeal papillomas. Future randomised controlled trials that directly compare the safety of different surgical modalities are needed.
23 May 2022Submitted to Clinical Otolaryngology
24 May 2022Submission Checks Completed
24 May 2022Assigned to Editor
06 Jun 2022Reviewer(s) Assigned
14 Jul 2022Review(s) Completed, Editorial Evaluation Pending
18 Jul 2022Editorial Decision: Revise Minor
21 Jul 20221st Revision Received
11 Aug 2022Submission Checks Completed
11 Aug 2022Assigned to Editor
12 Aug 2022Reviewer(s) Assigned
15 Aug 2022Review(s) Completed, Editorial Evaluation Pending
28 Aug 2022Editorial Decision: Revise Minor
30 Aug 20222nd Revision Received
20 Sep 2022Submission Checks Completed
20 Sep 2022Assigned to Editor
29 Sep 2022Reviewer(s) Assigned
15 Nov 2022Review(s) Completed, Editorial Evaluation Pending
10 Dec 2022Editorial Decision: Accept