A Network Meta-analysis Of Different Surgical Methods In The Treatment Of Labia Minor Hypertrophy

Objective:To compare the differences in curative effect of different treatments for labia minora hypertrophy by network meta-analysis.Methods:Based on computer systems to search for Embase,Pub Med,the Cochrane Library,Wanfang Medical Network,China National Knowledge Infrastructure(CNKI)and VIP,collect randomized controlled trials(RCT)on different treatments for labia minora hypertrophy.The retrieval time is from the establishment of the database to December2020.According to the pre-designed inclusion criteria and exclusion criteria,the literature was screened,and two researchers conducted data extraction and literature quality evaluation.The extracted information includes: first author,publication time,intervention measures,sample size,average age,average width of labia minora,outcome indicators(incision first-stage healing,complications,and patient satisfaction)and follow-up time.Rev Man5.3 and Stata14.0 software programs were used for data analysis.Results:A total of 788 patients were enrolled in 10 articles,involving 6 surgical methods,including curved double-pedicle flap method,epidermal suture,marginal resection,modified marginal resection,wedge resection,and single-pedicle tissue flap method.The results of network Meta analysis showed that there was no significant difference in the results of first-stage healing among the various surgical methods(P>0.05);the ranking of SUCRA value results: modified margin resection>single pedicle tissue flap method>margin resection>wedge resection>Epidermal suture>Curved double pedicle flap method.Wedge resection has a lower complication rate than marginal resection(RR=0.21,95%CI:0.08-0.59,P<0.05),and there is no statistically significant difference in the complication rate of other surgical methods(P > 0.05);SUCRA value ranking result ranking:marginal resection>single-pedicle tissue flap method>modified edge resection>curved double-pedicle flap method>epidermal suture>wedge resection.The satisfaction rate of patients with epidermal suture was higher than that of curved double-pedicle flap method(RR=1.25,95%CI:1.09-1.43,P <0.05),marginal resection(RR=0.77,95%CI:0.59-1.00,P <0.05)and single pedicle tissue flap method(RR=0.76,95%CI:0.58-1.00,P<0.05),there was no statistically significant difference in satisfaction with other surgical procedures(P >0.05);SUCRA value level The order of the results:epidermal suture>wedge resection>curved double-pedicle flap method>marginal resection>single-pedicle tissue flap method.Conclusion:For the treatment of labia minora,the complication rate of wedge resection is lower than that of marginal resection,and the satisfaction of patients with de-epidermal suture is higher than that of curved double-pedicle flap method,marginal resection and single-pedicle tissue flap method.The situation of first-stage healing after this operation is similar.In view of the limited quantity and quality of the included literature,the conclusions of this study need to be verified by more high-quality and large-sample randomized controlled trials in the future.