Techniques of staged laparoscopic orchidopexy for high intra-abdominal testes in children: A systematic review and meta-analysis
Background: 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 testic...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2024-01-01
|
| Series: | Urology Annals |
| Subjects: | |
| Online Access: | http://www.urologyannals.com/article.asp?issn=0974-7796;year=2024;volume=16;issue=1;spage=64;epage=70;aulast=Borkar |
| _version_ | 1797246038263726080 |
|---|---|
| author | Nitinkumar Bhajandas Borkar Charu Tiwari Debajyoti Mohanty Deepti Vepakomma Nilesh Nagdeve |
| author_facet | Nitinkumar Bhajandas Borkar Charu Tiwari Debajyoti Mohanty Deepti Vepakomma Nilesh Nagdeve |
| author_sort | Nitinkumar Bhajandas Borkar |
| collection | DOAJ |
| description | Background: 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.
Materials and Methods: 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.
Results: 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.
Conclusion: 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. |
| first_indexed | 2024-04-24T19:36:26Z |
| format | Article |
| id | doaj.art-7a91f5cecb004b068942039bd7888858 |
| institution | Directory Open Access Journal |
| issn | 0974-7796 0974-7834 |
| language | English |
| last_indexed | 2024-04-24T19:36:26Z |
| publishDate | 2024-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Urology Annals |
| spelling | doaj.art-7a91f5cecb004b068942039bd78888582024-03-25T13:07:50ZengWolters Kluwer Medknow PublicationsUrology Annals0974-77960974-78342024-01-01161647010.4103/ua.ua_11_23Techniques of staged laparoscopic orchidopexy for high intra-abdominal testes in children: A systematic review and meta-analysisNitinkumar Bhajandas BorkarCharu TiwariDebajyoti MohantyDeepti VepakommaNilesh NagdeveBackground: 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. Materials and Methods: 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. Results: 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. Conclusion: 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.http://www.urologyannals.com/article.asp?issn=0974-7796;year=2024;volume=16;issue=1;spage=64;epage=70;aulast=Borkarintra-abdominallaparoscopicorchidopexystagedtechniquesundescended testes |
| spellingShingle | Nitinkumar Bhajandas Borkar Charu Tiwari Debajyoti Mohanty Deepti Vepakomma Nilesh Nagdeve Techniques of staged laparoscopic orchidopexy for high intra-abdominal testes in children: A systematic review and meta-analysis Urology Annals intra-abdominal laparoscopic orchidopexy staged techniques undescended testes |
| title | Techniques of staged laparoscopic orchidopexy for high intra-abdominal testes in children: A systematic review and meta-analysis |
| title_full | Techniques of staged laparoscopic orchidopexy for high intra-abdominal testes in children: A systematic review and meta-analysis |
| title_fullStr | Techniques of staged laparoscopic orchidopexy for high intra-abdominal testes in children: A systematic review and meta-analysis |
| title_full_unstemmed | Techniques of staged laparoscopic orchidopexy for high intra-abdominal testes in children: A systematic review and meta-analysis |
| title_short | Techniques of staged laparoscopic orchidopexy for high intra-abdominal testes in children: A systematic review and meta-analysis |
| title_sort | techniques of staged laparoscopic orchidopexy for high intra abdominal testes in children a systematic review and meta analysis |
| topic | intra-abdominal laparoscopic orchidopexy staged techniques undescended testes |
| url | http://www.urologyannals.com/article.asp?issn=0974-7796;year=2024;volume=16;issue=1;spage=64;epage=70;aulast=Borkar |
| work_keys_str_mv | AT nitinkumarbhajandasborkar techniquesofstagedlaparoscopicorchidopexyforhighintraabdominaltestesinchildrenasystematicreviewandmetaanalysis AT charutiwari techniquesofstagedlaparoscopicorchidopexyforhighintraabdominaltestesinchildrenasystematicreviewandmetaanalysis AT debajyotimohanty techniquesofstagedlaparoscopicorchidopexyforhighintraabdominaltestesinchildrenasystematicreviewandmetaanalysis AT deeptivepakomma techniquesofstagedlaparoscopicorchidopexyforhighintraabdominaltestesinchildrenasystematicreviewandmetaanalysis AT nileshnagdeve techniquesofstagedlaparoscopicorchidopexyforhighintraabdominaltestesinchildrenasystematicreviewandmetaanalysis |