Comparison of Single-Incision Scrotal Orchiopexy and Traditional Two-Incision Inguinal Orchiopexy for Primary Palpable Undescended Testis in Children: A Systematic Review and Meta-Analysis

Frontiers in Pediatrics

article

Chengjun Yu¹  Yang Hu¹  Ling Wang¹  Lian Kang¹  Jie Zhao¹  Jiandong Lu¹  Tao Lin¹  Dawei He¹  Shengde Wu¹  Guanghui Wei¹ 

[1] Department of Urology, Children's Hospital of Chongqing Medical University;National Clinical Research Center for Child Health and Disorders;Chongqing Key Laboratory of Children Urogenital Development and Tissue Engineering;Ministry of Education Key Laboratory of Child Development and Disorders;Chongqing Key Laboratory of Pediatrics;China International Science and Technology Cooperation Base of Child Development and Critical Disorders

关键词: undescended testes;    orchiopexy;    single-incision;    minimal invasive surgery;    palpable undescended testes (PUDTs);    single-incision scrotal orchiopexy (SISO);    traditional two-incision inguinal orchiopexy (TTIO);    children;   

DOI  :  10.3389/fped.2022.805579

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Purpose To compare the safety, efficacy, and cosmetic results of single-incision scrotal orchiopexy (SISO) and traditional two-incision inguinal orchiopexy (TTIO) for primary palpable undescended testes (PUDTs) in children. Materials and Methods A systematic literature search of all relevant studies published on PubMed, Embase, Medline, Cochrane Library, Web of Science database, and Wanfang data until July 2021 was conducted. The operative time, hospitalization duration, conversion rate, wound infection or dehiscence, scrotal hematoma or swelling, testicular atrophy, reascent, hernia or hydrocele, analgesics needs, and cosmetic results were compared between SISO and TTIO using the Mantel–Haenszel or inverse-variance method. Results A total of 17 studies involving 2,627 children (1,362 SISOs and 1,265 TTIOs) were included in the final analysis. The conversion rate of SISO was 3.6%. The SISO approach had a statistically significant shorter operative time than the TTIO approach for PUDT (weighted mean difference−11.96, 95% confidence interval −14.33 to −9.59, I 2 = 79%, P < 0.00001) and a shorter hospital stay (weighted mean difference−1.05, 95% confidence interval −2.07 to −0.03, P = 0.04). SISO needed fewer analgesics and had better cosmetic results than TTIO. SISO had a similar total, short-term, or long-term complication rate with TTIO. Conclusion Compared with TTIO, SISO has the advantages of shorter operative time, shorter hospitalization duration, less postoperative pain, and better cosmetic appealing results. SISO is a safe, effective, promising, and potential minimal invasive surgical approach for PUDT. SISO is an alternative to TTIO in selected cryptorchid patients, especially for lower positioned ones.

【 授权许可】

CC BY