Techniques of staged laparoscopic orchidopexy for high intra-abdominal testes in children: A systematic review and meta-analysis

IF 0.7 Q4 UROLOGY & NEPHROLOGY
Urology Annals Pub Date : 2023-11-15 DOI:10.4103/ua.ua_11_23
N. Borkar, Charu Tiwari, Debajyoti Mohanty, Deepti Vepakomma, Nilesh Nagdeve
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Abstract

Laparoscopic exploration is currently considered the gold standard for managing nonpalpable intraabdominal testes. The problem of short vascular pedicle is addressed in Fowler-Stephen (FS) technique by the division of testicular vessels and in Shehata technique (ST) by traction on testicular vessels. There is a lack of the consensus among pediatric surgeons on the choice of one technique over other. This analysis compares the reported outcomes of staged laparoscopic orchidopexy by ST with the time tested FS technique in managing high intraabdominal undescended testis. The present systematic review and meta-analysis was conducted as per the preferred reporting items for the systematic review and meta-analyses guidelines. Only randomized controlled trials and comparative studies were included. The primary outcomes compared were the incidence of testicular atrophy, testicular retraction/ascent rate, and operative time of Stage I and Stage II orchidopexy. The present analysis was based on three randomized studies with a total of 119 undescended testes in 117 patients satisfying the inclusion criteria. The operative time was less in Stage I FS technique; however, there was no statistically significant difference in operative time of both procedures during the Stage II laparoscopic orchidopexy. Pooled analysis of postintervention testicular atrophy, testicular retraction rate, and duration of postoperative hospitalization showed no difference between both procedures. Both FS and STs are comparable in terms of postintervention testicular atrophy, testicular retraction/ascent; however, the mean operative time is significantly less with FS technique in Stage I laparoscopic orchidopexy.
分期腹腔镜睾丸切除术治疗儿童腹内高位睾丸的技术:系统回顾和荟萃分析
腹腔镜探查术目前被认为是处理腹腔内无法触及的睾丸的金标准。Fowler-Stephen 技术(FS)通过分割睾丸血管来解决血管蒂短的问题,而 Shehata 技术(ST)则通过牵引睾丸血管来解决血管蒂短的问题。小儿外科医生对选择哪种技术尚未达成共识。本分析比较了在处理腹腔内高位未降睾丸时,采用 ST 和久经考验的 FS 技术进行分期腹腔镜睾丸切除术的结果。 本系统综述和荟萃分析是根据系统综述和荟萃分析指南的首选报告项目进行的。仅纳入了随机对照试验和比较研究。比较的主要结果是睾丸萎缩的发生率、睾丸回缩/下降率以及一期和二期睾丸切除术的手术时间。 本分析基于三项随机研究,共有117名患者的119个未降睾丸符合纳入标准。第一阶段FS技术的手术时间较短;但在第二阶段腹腔镜睾丸切除术中,两种手术的手术时间差异无统计学意义。对干预后睾丸萎缩、睾丸回缩率和术后住院时间的汇总分析表明,两种手术没有差异。 在干预后睾丸萎缩、睾丸回缩/下降方面,FS和ST具有可比性;但在腹腔镜睾丸固定术第一阶段中,FS技术的平均手术时间明显更短。
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来源期刊
Urology Annals
Urology Annals UROLOGY & NEPHROLOGY-
CiteScore
1.20
自引率
0.00%
发文量
59
审稿时长
31 weeks
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