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Therapeutic efficacy and safety of laparoscopic surgery versus microsurgery for varicocele of adult males: A meta-analysis.

Abstract This study aimed to systemically evaluate the efficacy and safety of laparoscopy versus microsurgery in the surgical therapy of varicocele in male adults.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 28834886
OWN - NLM
STAT- In-Process
DA  - 20170823
LR  - 20170823
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 34
DP  - 2017 Aug
TI  - Therapeutic efficacy and safety of laparoscopic surgery versus microsurgery for
      varicocele of adult males: A meta-analysis.
PG  - e7818
LID - 10.1097/MD.0000000000007818 [doi]
AB  - OBJECTIVES: This study aimed to systemically evaluate the efficacy and safety of 
      laparoscopy versus microsurgery in the surgical therapy of varicocele in male
      adults. METHODS: Relevant literature, published between January 1995 and October 
      2012, were searched in Pubmed/Medline database, OVID, EMBASE, Chinese Biology
      Medicine disc (CBMdisc), CNKI, CEBM\CCD, and Cochrane database. The newly
      published papers were also manually searched. Randomized controlled trials (RCT) 
      related to the surgical interventions of varicocele were included, and full texts
      were obtained. Each study was evaluated with the Cochrane Risk of Bias tool. Two 
      investigators collected data independently to produce the meta-analysis. RESULTS:
      Five RCTs met the inclusion criteria and included 554 patients. Data were merged 
      by the RevMan5.1 software. The sperm concentration increased significantly after 
      surgery (WMD = 4.28; 95% CI = 4.16, 6.99; P < .00001, Z = 7.72). There was no
      significant difference in the postoperative hospital stay between laparoscopy and
      microsurgery (WMD = 0.24, 95% CI = 0.44, 0.93; P = .49, Z = 0.69). The operation 
      time of laparoscopy was significantly shorter than that of microsurgery (WMD =
      40.31, 95% CI = 37.77, 42.86; P < .00001, Z = 31.03). The incidence of hydrocele 
      reduced significantly after microsurgery as compared to laparoscopy (WMD = 0.05, 
      95% CI = 0.01, 0.27; P = .0005, Z = 3.49). The postoperative recurrence rate
      after microsurgery was significantly lower than that after laparoscopy (WMD =
      0.10, 95% CI = 0.04, 0.25; P < .00001, Z = 5.01). CONCLUSION: No significant
      differences were found between microsurgery and laparoscopy for the increase of
      sperm concentration and operation time. Compared to the laparoscopy group, the
      microsurgery group had lower postoperative incidence of hydrocele and recurrence 
      rate, but longer in the operation time.
FAU - Wu, Xueliang
AU  - Wu X
AD  - aAndrology Center bDepartment of Anorectal Surgery, People's Hospital of
      Ningxiang County, Hunan University of Traditional Chinese Medicine Affiliated
      Ningxiang People's Hospital, Changsha, Hunan, China.
FAU - Liu, Qingbo
AU  - Liu Q
FAU - Zhang, Ruiming
AU  - Zhang R
FAU - Wang, Wei
AU  - Wang W
FAU - Gao, Yong
AU  - Gao Y
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
EDAT- 2017/08/24 06:00
MHDA- 2017/08/24 06:00
CRDT- 2017/08/24 06:00
AID - 10.1097/MD.0000000000007818 [doi]
AID - 00005792-201708250-00023 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Aug;96(34):e7818. doi: 10.1097/MD.0000000000007818.