Study Selection and Quality Assessment
A total of 801 studies identified from the literature search were exported into EndNote software, along with 5 additional records identified through other sources. Duplicates were removed automatically and manually, leaving 351 studies to screen. The selection of the studies was performed independently by two authors (Liu. and Wang.). Publications were evaluated dependent on predefined inclusion and exclusion criteria.
Inclusion criteria were as follows: (1) Randomized controlled, prospective or retrospective observational studies; (2) Patients were diagnosed with recurrent respiratory papillomas by histological pathological examination; (3) Patients agreed to undergo surgical treatment with microdebrider or CO2 laser or KTP laser;(4) Outcomes of interest were intraoperative and postoperative complications, and complication rates.
The following exclusion criteria were adopted: (1) Case reports, editorials, reviews and short communications; (2) Adjuvant therapies simultaneously;(3) Sample size≤5; (4) The target outcomes is not available. Data extraction from each included study was performed on the basis of study characteristics and predefined outcome variables. The following variables were retrieved from each study: year of publication, study design, surgery modality (microdebrider or CO2 laser or KTP laser), number of surgeries, intraoperative and postoperative complications, complication rates. Discrepancies were resolved by discussion. The methodological quality assessment was performed following the Newcastle Ottawa Scale[23].