title: Efficacy of mitomycin C in endoscopic dacryocystorhinostomy: a systematic review and meta-analysis.
abstract: BACKGROUND
  A number of published comparative studies have been conducted to evaluate the efficacy and safety of intraoperative mitomycin C (MMC) in endoscopic dacryocystorhinostomy (EN-DCR). However, results have not always been consistent. Therefore, we carried out a meta-analysis to compare the clinical results of EN-DCR with and without MMC.
  
  
  RESULTS
  A comprehensive literature search of Cochrane Library, PubMed and EMBASE to identify relevant trials comparing EN-DCR with and without MMC. Eleven studies including 574 eyes were included in this meta-analysis. The success was defined as patency of the nasolacrimal canal and symptomatic improvement. There was significantly higher success rate in the MMC group in comparison with control group [RR = 1.12, 95% CI (1.04, 1.20), P = 0.004]. A sensitivity analysis after the non-randomized controlled trials were excluded from the meta-analysis demonstrated no differences compared with the overall results. Subgroup analyses showed that MMC group had a significantly higher success rate than control group in primary and revision EN-DCR, and EN-DCR without silicone intubation, but no difference in the subgroup of with silicone intubation. The size of the osteotomy site was bigger in the MMC group compared to the control group at 3 months [WMD = 7.65, 95% CI (0.33, 14.98), P = 0.041] and 6 months [WMD = 9.28, 95% CI (2.45, 16.11), P = 0.008] after surgery. However, there was statistically significant difference in the osteotomy surface area between the two groups at 12 months after surgery [WMD = 11.63, 95% CI (-1.04, 24.29), P = 0.072].
  
  
  CONCLUSIONS
  Intraoperative MMC application seems to be a safe adjuvant that could reduce the closure rate of the osteotomy and enhance the success rate after both primary and revision EN-DCR.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01772277.
authors.affiliation: Department of Ophthalmology, Taihe Hospital Affiliated to Hubei University of Medicine, Hubei, China.
authors.forename: Shi-ming
authors.initials: SM
authors.lastname: Cheng
authors.forename: Yi-fan
authors.initials: YF
authors.lastname: Feng
authors.forename: Ling
authors.initials: L
authors.lastname: Xu
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.forename: Jin-hai
authors.initials: JH
authors.lastname: Huang
mesh_terms: D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use*; D003608:Dacryocystorhinostomy; D016206:Databases, Bibliographic; D004724:Endoscopy; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D007767:Lacrimal Duct Obstruction / Q000473:pathology; D008297:Male; D016685:Mitomycin / Q000627:therapeutic use*; D009301:Nasolacrimal Duct / Q000187:drug effects / Q000473:pathology / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic
chemical_list: D000903:Antibiotics, Antineoplastic; D016685:Mitomycin