Proximal Anal Sinus Resection as an Advanced Operation to Fistulectomy and Seton for Reducing Recurrence Rate

2019 ◽  
Author(s):  
Chao Lei ◽  
Chao Li ◽  
Ting Liu ◽  
Min Liu ◽  
Chen Li ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Anal Fistula ◽  
Surgical Complications ◽  
Healing Time ◽  
First Line ◽  
Lower Recurrence Rate ◽  
Surgery Group ◽  
Significant Difference ◽  
Patients At Risk ◽  
Wound Healing Time

Abstract Background The recurrence rate of classic surgery for anal fistula has always been one of the troublesome problems. The purpose of this study was to mainly compare the recurrence rate between classic surgery (fistulectomy or seton) and proximal anal sinus resection (PASR) in case-control study.Methods 106 patients who suffered from anal fistula were taken into classic surgery group (n=74) and PASR group (n=32), Then we analyzed the recurrence rate, wound healing time, surgical complications, and duration of the pain.Results There was a significant difference in the recurrence rate between classic surgery group and PASR group (16.2% vs 0%). The duration of pain, mean healing time and surgical complications in the two groups had no significant difference (P>0.05).Conclusion PASR had shown lower recurrence rate and did not increase the risk of complications, and could be considered as a first line of treatment for patients at risk of recurring for anal fistula.

scholarly journals Efficacy of Ruiyun procedure for hemorrhoids combined simplified Milligan–Morgan hemorrhoidectomy with dentate line-sparing in treating grade III/IV hemorrhoids: a retrospective study

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qiuxiang Yu ◽  
Congcong Zhi ◽  
Lansi Jia ◽  
Hui Li
Keyword(s):  
Wound Healing ◽  
Postoperative Complications ◽  
Recurrence Rate ◽  
Dentate Line ◽  
Healing Time ◽  
Post Operation ◽  
Time Required ◽  
Wound Healing Time ◽  
Normal Work ◽  
Grade Iii

Abstract Background Hemorrhoids are common. Hemorrhoidectomy should typically be offered to patients whose symptoms result from external hemorrhoids or combined internal and external hemorrhoids with prolapse (grades III/IV). However, none of the currently used surgical methods could be considered an ideal surgical option that is effective, safe, and painless. We hypothesized that a combination of Ruiyun procedure for hemorrhoids (RPH) and simplified Milligan–Morgan hemorrhoidectomy (sMMH) will increase the safety and effectiveness of surgical treatment hemorrhoids. This study aimed to evaluate the efficacy of Ruiyun procedure for hemorrhoids combined simplified Milligan–Morgan hemorrhoidectomy with dentate line-sparing (RPH + sMMH) to treat grade III/IV hemorrhoid. Methods Total 452 patients with hemorrhoids of grade III/IV were retrospectively reviewed in China-Japan Friendship Hospital, 244 cases were assigned to RPH + sMMH group, and 208 cases in MMH group. The primary efficacy outcome was rate of curative at 3 month after operation, and the recurrence rate within 12 months post operation. Secondary efficacy outcomes included wound healing time, time required to resume normal work, constipation symptom, quality of life, and pain post operation was also evaluated. The safety outcome included postoperative complications. Results There were no differences between the two groups in demographic characteristics. There was no statistically significant difference between the two groups in the curative rate. The recurrence rate after 12 months post operation in the RPH + sMMH (3.0%) was significantly lower than the sMMH group (7.8%) (P = 0.032). The wound healing time was significantly shorter in RPH + sMMH group than that in MMH group (P < 0.001). The time required to resume normal work in the RPH + sMMH group was significantly shorter than MMH group (P < 0.001). Compared with the MMH group, the RPH + sMMH therapy preserve better life quality and lower constipation symptom (all P < 0.05). Patients who underwent RPH + sMMH had significantly less postoperative pain than MMH therapy. The total rate of patients with postoperative complications in the RPH + sMMH group (8.6%) was significant lower than the MMH group (16.3%) (P = 0.012). Conclusion RPH + sMMH may more effective in treating patients with III/IV hemorrhoids, which indicated lower recurrence rate, lower postoperative complications and pain, shorter recovery and return to normal life.

Treatment of Complex Anal Fistula by Video-Assisted Anal Fistula Treatment Combined with Anal Fistula Plug: A Single-Center Study

2021 ◽  
pp. 155335062199292
Author(s):  
Yuru Zhang ◽  
Fei Li ◽  
Tuanjie Zhao ◽  
Feng Cao ◽  
Yamin Zheng ◽  
...  
Keyword(s):  
Wound Healing ◽  
Anal Fistula ◽  
Healing Time ◽  
Sphincter Function ◽  
Anal Sphincter Function ◽  
Fistula Plug ◽  
Anal Fistula Plug ◽  
Fistula Treatment ◽  
Wound Healing Time

Objective. The surgical treatment of complex anal fistulae is very challenging because of the incidence of incontinence after traditional approaches. There are no studies on the role of video-assisted anal fistula treatment (VAAFT) combined with anal fistula plug (AFP) in the complex anal fistulae. The aim of this study was to demonstrate the efficacy of treating complex anal fistulae using VAAFT combined with AFP. Method. This was a retrospective, nonrandomized observational study. 57 consecutive patients with complex anal fistulae who had undergone the VAAFT with AFP in our hospital between April 2016 and December 2019 were included. The primary outcomes were the cure rate, recurrence rate, and Wexner incontinence scores; the secondary outcomes were surgery time, blood loss, wound healing time postoperatively, pain, and patient satisfaction. Results. All 57 patients completed the surgery and follow-up, with an average follow-up time of 28 months; 6 patients suffered with recurrence (recurrence rate: 10.5%). The average surgery time was 57.9 minutes, and the average wound healing time was 46 days. There were no severe postoperative complications, and anal sphincter function was protected in all patients. Conclusions. The treatment of complex anal fistula by VAAFT combined with AFP is safe and effective, has a high healing rate and few postoperative complications, and is a promising surgery that can effectively protect the patient’s anal sphincter function.

scholarly journals Treatment of acute acquired concomitant esotropia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Minghua Shi ◽  
Yuanxiang Zhou ◽  
Aijiao Qin ◽  
Jing Cheng ◽  
Hongxing Ren
Keyword(s):  
Botulinum Toxin ◽  
Success Rate ◽  
Recurrence Rate ◽  
Botulinum Toxin Injection ◽  
Medial Rectus ◽  
Good Effect ◽  
Surgery Group ◽  
Significant Difference ◽  
Before And After ◽  
Initial Success Rate

Abstract Background The treatment efficacy of botulinum toxin bilateral medial rectus injections for acute acquired concomitant esotropia (AACE) in adult is not clear. We characterize the effects of botulinum toxin injection in the treatment of AACE, especially in patients over 14 years old, and compared it with surgical treatment. Methods In this prospective, nonrandomized, controlled clinical study, patients with AACE in our hospital from March 2017 to March 2020 elected to receive bilateral medial rectus injections of botulinum toxin or to undergo extraocular muscle surgery. Ocular position and stereopsis were evaluated before and after treatment. Results A total of 60 patients were treated: 40 patients in the botulinum toxin group, and 20 patients in the surgery group. The botulinum toxin group included 31 cases ≥ 14 years of age and 9 cases < 14 years of age. After 1–3 botulinum injections, the cumulative initial success rate was 95% (38/40), and the recurrence rate was 22.5% (9/40). Nine children < 14 years of age were treated successfully, without recurrence. In the surgery group, the initial success rate after surgery was 75% (17/20), and the recurrence rate was 20% (4/20). There was no significant difference between groups in the rate of success rate or the rate of recurrence (P > 0.05). Conclusion The injection of botulinum toxin has a good effect on AACE in adults and children. The outcomes achieved with injected botulinum toxin are similar to those achieved with surgery. Trial registration ChiCTR, ChiCTR2000032544. Registered May 2, 2020, Retrospectively registered.

scholarly journals Treatment of Acute Acquired Concomitant Esotropia

2020 ◽  
Author(s):  
Minghua Shi ◽  
Yuanxiang Zhou ◽  
Aijiao Qin ◽  
Jing Chen ◽  
Hongxing Ren
Keyword(s):  
Botulinum Toxin ◽  
Success Rate ◽  
Recurrence Rate ◽  
Botulinum Toxin Injection ◽  
Medial Rectus ◽  
Good Effect ◽  
Surgery Group ◽  
Significant Difference ◽  
Before And After ◽  
Initial Success Rate

Abstract Background: The treatment efficacy of botulinum toxin bilateral medial rectus injections for acute acquired concomitant esotropia (AACE) in adult is not clear. We characterize the effects of botulinum toxin injection in the treatment of AACE, especially in patients over 14 years old,and compared it with surgical treatment.Methods: In this prospective, nonrandomized, controlled clinical study, patients with AACE in our hospital from March 2017 to March 2020 elected to receive bilateral medial rectus injections of botulinum toxin or to undergo extraocular muscle surgery. Ocular position and stereopsis were evaluated before and after treatment.Results: A total of 60 patients were treated: 40 patients in the botulinum toxin group, and 20 patients in the surgery group. The botulinum toxin group included 31 cases ≥14 years of age and 9 cases <14 years of age. After 1–3 botulinum injections, the cumulative initial success rate was 95% (38/40), and the recurrence rate was 22.5% (9/40). Nine children <14 years of age were treated successfully, without recurrence. In the surgery group, the initial success rate after surgery was 75% (17/20), and the recurrence rate was 20% (4/20). There was no significant difference between groups in the rate of success rate or the rate of recurrence (P>0.05).Conclusion: The injection of botulinum toxin has a good effect on AACE in adults with minimal squinting and in children. The outcomes achieved with injected botulinum toxin are similar to those achieved with surgery.Trial registration: ChiCTR, ChiCTR2000032544. Registered May 2, 2020，Retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=52349

Stent assisted coiling versus non-stent assisted coiling for the management of ruptured intracranial aneurysms: a meta-analysis and systematic review

2019 ◽  
Vol 11 (5) ◽  
pp. 489-496 ◽  
Author(s):  
Xiaoxi Zhang ◽  
Qiao Zuo ◽  
Haishuang Tang ◽  
Gaici Xue ◽  
Pengfei Yang ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Recurrence Rate ◽  
Complication Rate ◽  
Intracranial Aneurysms ◽  
Meta Analysis ◽  
Lower Recurrence Rate ◽  
Significant Difference ◽  
Favorable Clinical Outcome ◽  
Ruptured Intracranial Aneurysms

PurposeTo compare the safety and efficiency of stent assisted coiling (SAC) with non-SAC for the management of ruptured intracranial aneurysms.MethodsA meta-analysis that compared SAC with coiling alone and balloon assisted coiling was conducted by database searching. The primary outcomes of this study were immediate occlusion and progressive thrombosis rate, overall perioperative complication rate, and angiographic recurrence. Secondary outcomes included mortality at discharge, hemorrhagic and ischemic complications, and favorable clinical outcome at discharge and at follow-up.ResultsEight retrospective cohort studies with 1408 ruptured intracranial aneurysms (SAC=499; non-SAC=909) were included. The SAC group tended to show a lower immediate complete occlusion rate than the non-SAC group (54.3% vs 64.2%; RR 0.90; 95% CI 0.83 to 0.99; I2=17.4%) and achieved a significantly higher progressive complete rate at follow-up (73.4% vs 61.0%; RR 1.30; 95% CI 1.16 to 1.46; I2=40.5%) and a lower recurrence rate (4.8% vs 16.6%; RR 0.28; 95% CI 0.16 to 0.50; I2=0.0%). With respect to safety concerns, overall perioperative complications in the SAC group were significantly higher (20.2% vs 13.1%; RR 1.70; 95% CI 1.36 to 2.11; I2=0.0%). However, no significant difference was found for mortality rate at discharge (6.3% vs 6.2%; RR 1.29; 95% CI 0.86 to 1.94; I2=0.0%), or favorable clinical outcome rate at discharge (73.4% vs 74.2%; RR 0.95; 95% CI 0.88 to 1.02; I2=12.1%) and at follow-up (85.6% vs 87.9%; RR 0.98; 95% CI 0.93 to 1.02; I2=0.0%; P=0.338).ConclusionsSAC has a lower recurrence rate than non-SAC. Nevertheless, further validation by well designed prospective studies is warranted for determining whether stents improve angiographic outcome without an increased complication rate or unfavorable clinical outcome.

Sinus pilonidalis fisztuloszkópos kezelése gyermekekben

2021 ◽  
Vol 162 (43) ◽  
pp. 1740-1743
Author(s):  
Balázs Fadgyas ◽  
Márk Langer ◽  
Zoltán Ringwald
Keyword(s):  
Wound Healing ◽  
Adverse Events ◽  
Hospital Stay ◽  
Recurrence Rate ◽  
Pilonidal Sinus ◽  
Pilonidal Disease ◽  
Healing Time ◽  
Sinus Pilonidalis ◽  
Everyday Activity ◽  
Wound Healing Time

Összefoglaló. Bevezetés: A sinus pilonidalis nehezen kezelhető, sok szövődménnyel és recidívával járó betegség. A legtöbb műtéti eljárás többnapos kórházi kezelést, munkából vagy iskolából való hiányzást követel. Célkitűzés: Munkánk célja, hogy a PEPSiT- (pediatric endoscopic pilonidal sinus treatment) műtétek eredményességét vizsgálja. Módszer: Intézetünkben 2019–2020-ban PEPSiT-műtéten átesett, 18 év alatti betegeket válogattunk be a vizsgálatba. Kizártuk a cisztoszkóppal operált és kontrollra nem jelentkező betegeket. A szövődmények, recidívák számát, a kórházi tartózkodás hosszát, a sebgyógyulás és a hétköznapi aktivitáshoz való visszatérés idejét vizsgáltuk. Eredmények: Betegeink többsége fiú (24 fiú, 4 lány), átlagéletkoruk 15,6 év volt. 28 betegen 31 PEPSiT-beavatkozást végeztünk (3 re-PEPSiT), 6 recidíva, 1 sebgennyedés alakult ki. A betegek egy része egynapos ellátás keretében, míg a többség egy éjszaka bentfekvés után tért haza (1,74 nap ápolási idő). A hétköznapi aktivitáshoz 1,37 nap után tértek vissza, a gyógyulási idő 5,9 hét volt átlagosan. Megbeszélés: A PEPSiT-beavatkozás minimálisan invazív lehetőség, igen rövid kórházi tartózkodással. A betegek hamar térnek vissza a szokott aktivitásukhoz, a korábbi sipolyon kívül újabb műtéti seb nem alakul ki. A recidívaarány hasonló az egyéb technikákéhoz. Következtetés: A PEPSiT-beavatkozás jól alkalmazható, a recidívaarány csökkentése fontos. Orv Hetil. 2021; 162(43): 1740–1743. Summary. Introduction: The treatment of pilonidal disease is often challenging, due to frequent recurrences and adverse events. Most operative treatments require a lengthy hospital stay, and absence from school or work. Objective: We aimed towards assessing the effectivity of PEPSiT (pediatric endoscopic pilonidal sinus treatment). Method: In this study, we included patients subjected to PEPSiT from 2019 to 2020 between ages 0–18 years. Patients operated via cystoscope and patients who did not attend follow-up examinations were excluded. Adverse events, recurrences, length of hospital stay, wound healing time and return to everyday activity were assessed. Results: The majority of our patients were male (24 male, 4 female), the mean age was 15.6 years. 31 PEPSiT operations were recorded on 28 patients (3 were redo surgeries). 6 recurrences and 1 wound suppuration were documented. Some patients were treated within the confines of one-day surgery, while most of them stayed one night (mean length of stay was 1.74 days). Return to everyday activity was an average 1.37 days, and mean wound healing time was 5.9 weeks. Discussion: PEPSiT is a minimally invasive operative approach with a very short hospital stay. Patients return to everyday activity faster. New operative scarring does not happen apart from the preexisting fistula opening. Recurrence rate is similar to that of other treatment techniques. Conclusion: PEPSiT technique is applicable, however, reduction of the recurrence rate is important. Orv Hetil. 2021; 162(43): 1740–1743.

scholarly journals TYMPANOPLASTY TYPE-1: DIFFERENT APPROACHES AND THEIR SURGICAL OUTCOMES

2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S495-99
Author(s):  
Fazal I Wahid ◽  
Abdul Manan ◽  
Muhammad Saleem ◽  
Bakht Zada ◽  
Habib -Ur- Rehman ◽  
...  
Keyword(s):  
Wound Healing ◽  
Postoperative Pain ◽  
Surgical Outcomes ◽  
Neck Surgery ◽  
Healing Time ◽  
Cross Sectional ◽  
Female Ratio ◽  
Significant Difference ◽  
Wound Healing Time

Objective: To calculate the surgical outcomes of different approaches of tympanoplasty type 1 in terms of air bone gap closure, wound healing, and postoperative pain. Study Design: Prospective cross-sectional study. Place and Duration of Study: Department of ENT, Head and Neck Surgery, Medical Teaching Institute (MTI), Lady Reading Hospital (LRH), Peshawar, Pakistan from Jun 2018 to May 2020. Methodology: Size of sample was 75 patients divided into three groups. Consent was obtained from all the patients included in study. After proper evaluation and relevant investigation pre- and post-operative PTA was performed. Tympanoplasty type-1 was performed by the same surgeon by the three approaches following established otological surgical protocol. Collected data was entered in SPSS-25 for analysis. Results: All 75 patients were divided into three equal groups. Male were 55 (73.3%), females were 20 (26.7%). Male: female ratio was 2.7:1. Majority of patients presented in 2nd and 3rd decades of life 31 (41.33%) and 28 (37.33%) respectively. Preoperative mean ± SD, ABG in groups A, B and C were 37.60 ± 11.28 dB, 37 ± 9.68 dB and 31.80 ± 12.40 dB, respectively. No significant difference was found amongst the three groups regarding pre-operative and post-operative ABG (p=0.85 and p=0.4), respectively. Mean ± SD, wound healing time in Groups A, B and C were 1.00 ± 0.00, 1.80 ± 0.40 and 1.76 ± 0.43 respectively with p=0.0001 and similarly postoperative pain with p=0.001. The wound healing time and post-operative was statistically better (p<0.05) in group A (Transmeatal approach) than other groups........

scholarly journals Arthroscopic Bankart Repair Versus Open Latarjet for Recurrent Shoulder Instability in Athletes

2021 ◽  
Vol 9 (9) ◽  
pp. 232596712110238
Author(s):  
Eoghan T. Hurley ◽  
Martin S. Davey ◽  
Connor Montgomery ◽  
Ross O’Doherty ◽  
Mohamed Gaafar ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Shoulder Instability ◽  
Return To Play ◽  
Bankart Repair ◽  
Level Of Evidence ◽  
Lower Recurrence Rate ◽  
Recurrent Shoulder Instability ◽  
Arthroscopic Bankart Repair ◽  
Significant Difference

Background: In athletes with recurrent shoulder instability, arthroscopic Bankart repair (ABR) and the open Latarjet procedure (OL) are commonly indicated to restore stability and allow them to return to play (RTP). Purpose: To compare the outcomes of ABR and OL in athletes with recurrent shoulder instability. Study Design: Cohort study; Level of evidence, 3. Methods: We performed a retrospective review of patients with recurrent shoulder instability who underwent ABR and OL and had a minimum 24-month follow-up. Indications for OL over ABR in this population were those considered at high risk for recurrence, including patients with glenohumeral bone loss. The patients were pair-matched in a 1:1 ratio (OL and ABR) by age, sex, sport, and level of preoperative play. We evaluated the rate, level, and timing of RTP, and the Shoulder Instability–Return to Sport after Injury (SIRSI) score between procedures. Additionally we compared the recurrence rate, visual analog scale (VAS) pain score, Subjective Shoulder Value (SSV), Rowe score, satisfaction, and whether patients would undergo the same surgery again. Results: Participants included 62 athletes who underwent ABR and 62 who underwent OL, with a mean follow-up of 47.7 months. There was no significant difference between ABR and OL in rate of RTP, return to preinjury level, time to return, SIRSI score, VAS score, SSV, or patient satisfaction. OL resulted in a significantly lower recurrence rate (1.6% vs 16.1% for ABR; P = .009) and a significantly higher Rowe score (mean ± SD, 90.5 ± 12.2 vs 82.2 ± 20.8 for ABR; P = .008). In collision athletes, there was no significant difference between ABR and OL regarding RTP rate (89.1% vs 94.5%; P = .489) or SIRSI score (70.4 ± 24.8 vs 73.8 ± 19.6; P = .426), but OL resulted in a lower recurrence rate (14.5% vs 1.8%; P = .031). Conclusion: ABR and OL resulted in excellent clinical outcomes, with high rates of RTP in athletes. However, lower recurrence rates were seen with OL.

scholarly journals Laser Surgery for Treating Retarded Teeth Eruption in Children

2021 ◽  
Author(s):  
Dan Xu ◽  
Peipei Wang ◽  
Hualian Liu ◽  
Min Gu
Keyword(s):  
Pain Intensity ◽  
Laser Surgery ◽  
Operative Time ◽  
Healing Time ◽  
Total Operative Time ◽  
Surgery Group ◽  
Significant Difference ◽  
Pain Duration ◽  
Group A ◽  
Group B

Abstract Objective: To analyze the efficacy of laser surgery in treating retarded eruption in children.Method: Sixty-three children (age：7-13 ，30 boys and 33 girls)were selected and according to the random number table divided into three groups: Laser surgery group (group A), electrosurgery group (group B), and routine surgery group (group C).The total operative time, the duration of pain after gingival excision, and VAS pain intensity scores, gingival healing time, and intraoperative coordination were all recorded . Pain intensity was assessed using a Visual Analogue Scale (VAS) score (0 to 100mm). At six months during the follow-up, this physician checked and recorded the periodontal indicators of permanent teeth, including gum index (GI), plaque index (PLI), and probing depth (PD).Results: All teeth erupted normally in three groups after treatment, showing normal pulp and periodontal tissue. There was no significant difference in operative time, pain duration, pain intensity, healing time between group A and group B. There was a significant difference in total operative time, pain duration, pain intensity, and healing time between electrosurgery group (group B) and routine surgery group (group C) (P<0.05).There was a significant difference in total operative time, pain duration, pain intensity, and healing time between laser surgery group (group A) and routine surgery group (group C) (P<0.05).Periodontal indexes, including gingival indexes, plaque indexes, were examined in three groups at six months after treatment by the same periodontist. Then, the efficacy of the three methods was compared.Conclusion: Laser surgery and high-frequency electrosurgery has favorable efficacy, less pain, and higher operability. However, in the use of the electric knife, the paste flavor may discomfort the children, make them less cooperative, and prolong the procedures.

scholarly journals Aspiration-Sclerotherapy Versus Laparoscopic De-roofing in the Treatment of Renal Cysts: Which is better?

2020 ◽  
Author(s):  
Xueling Zhang ◽  
Dehong Cao ◽  
Peizhen Han ◽  
Zhengju Ren ◽  
Jia Wang ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Web Of Science ◽  
Treatment Time ◽  
Renal Cyst ◽  
Meta Analysis ◽  
Renal Cysts ◽  
Lower Recurrence Rate ◽  
Significant Difference ◽  
Review Manager ◽  
Comprehensive Literature Search

Abstract Purpose: To compare the clinical efficiency between aspiration-sclerotherapy (AS) and laparoscopic de-roofing (LD) in the management of renal cysts through meta-analysis of comparative studies. Method: A comprehensive literature search was performed by PubMed, MEDLINE, Ovid and Web of Science for relevant studies published up to January 2020. The statistical analyses were conducted with Review Manager 5.3.0 and Stata 15.1. The sensitivity analysis was also carried out to confirm the reliability of this Meta-analysis. Results: Our searches of literature generated 6 studies (1547 patients incorporated) comparing AS with LD in the impacts of renal cyst therapy. Of these, 6 studies contained 1106 and 441 patients who were treated with AS and LD, respectively. The outcome of this meta-analysis indicated that LD group was superior in symptomatic successful rate [Odds Ratio(OR): 0.28; 95%Confidence Interval(CI): 0.09 to 0.86；P=0.03), radiological successful rate (OR: 0.06; 95%CI: 0.02 to 0.15; P<0.01) and recurrence rate (OR: 6.08; 95%CI: 2.81 to 13.15; p<0.01). Nevertheless, AS group had shorter treatment time [Mean Difference(MD)：-51.10; 95% CI：-73.01 to -29.20; p<0.01]. No statistically significant difference was showed in the rate of complications (OR: 3.19; 95% CI: 0.39 to 25.88; P=0.28). Conclusion: In our meta-analysis, LD had higher symptomatic successful rate, radiological successful rate as well as lower recurrence rate than AS, while the treatment time was longer.

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