ObjectiveThe aim of this meta-analysis is to compare the outcomes of early endonasal dacryocystorhinostomy (DCR) with delayed DCR in the treatment of acute dacryocystitis (AD).MethodsA comprehensive electronic search of PubMed, Embase, Web of Science, and the Cochrane Library databases was conducted up to November 11, 2023. Data synthesis was performed using Review Manager 5.4, and forest plots were generated for each outcome measure. Potential publication bias was assessed using funnel plots and Egger's test.ResultsSix studies involving 288 patients were included in the meta-analysis. Overall, the success rate of early endonasal DCR was comparable to that in the delayed DCR group (odds ratio [OR] = 1.52, 95% confidence interval [CI]: 0.81-2.85, P = .19). Furthermore, in comparison with the delayed DCR group, early endonasal DCR significantly reduced the time for medial canthus swelling resolution (mean differences [MD] = −4.92, 95% CI: −5.46 to 4−.37, P < .00001) and complete resolution of symptoms (MD = −17.70, 95% CI: −23.88 to −11.52, P < .00001).ConclusionPrimary early endonasal DCR seems to be a promising and favorable approach for managing AD with comparable efficacy and faster relief of symptoms compared to conventional delayed DCR.

中文翻译：

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早期鼻内泪囊鼻腔吻合术治疗急性泪囊炎：系统评价和荟萃分析


目的本荟萃分析的目的是比较早期鼻内泪囊鼻腔吻合术 (DCR) 与延迟 DCR 治疗急性泪囊炎 (AD) 的结果。方法对 PubMed、Embase、Web of Science 和 Cochrane 图书馆数据库进行全面电子检索调查持续至 2023 年 11 月 11 日。使用 Review Manager 5.4 进行数据合成，并为每个结果指标生成森林图。使用漏斗图和 Egger 检验评估潜在的发表偏倚。结果 荟萃分析中纳入了涉及 288 名患者的六项研究。总体而言，早期鼻内 DCR 的成功率与延迟 DCR 组相当（比值比 [OR] = 1.52，95% 置信区间 [CI]：0.81-2.85，P = .19）。此外，与延迟 DCR 组相比，早期鼻内 DCR 显着缩短了内眦肿胀消退的时间（平均差 [MD] = -4.92，95% CI：-5.46 至 4−.37，P < .00001）并且症状完全缓解（MD = -17.70，95% CI：-23.88 至 -11.52，P < .00001）。 结论 初级早期鼻内 DCR 似乎是治疗 AD 的一种有前途且有利的方法，与相比，其疗效相当且症状缓解更快与传统的延迟 DCR 相比。