Utility of Laparoscopic Approach of Orchiopexy for Palpable Cryptorchidism: A Systematic Review and Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Source and Search Strategy
2.2. Eligibility Criteria
2.3. Data Synthesis
2.4. Quality Assessment
2.5. Statistical Analysis
3. Results
3.1. Study Characteristics
3.2. Summary of the Included Studies
3.2.1. Escarcega-Fujigaki et al., 2011
3.2.2. Elderwy et al., 2014
3.2.3. Saka et al., 2020
3.2.4. Yang et al., 2020
3.2.5. Gu et al., 2021
3.3. Methodological Quality Assessment
3.3.1. Meta-Analysis of Outcomes—Recurrence of Cryptorchidism and Need for Redo-Orchiopexy
3.3.2. Meta-Analysis of Outcomes—Incidence of Early Postoperative Complications
3.3.3. Meta-Analysis of Outcomes—Incidence of Testicular Atrophy (Late Complication)
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
Database | Studies |
PubMed | 169 |
EMBASE | 13 |
Web of Science | 72 |
SCOPUS | 59 |
Total | 313 |
Duplications | 110 |
After Duplication Removal | 203 |
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Author, Year | Study Design | Sample Size | Mean (SD)/Median (IQR) Age; in Years | Unilateral Cases (%) | Follow-Up Period | |||
---|---|---|---|---|---|---|---|---|
LO | CO | LO | CO | LO | CO | |||
Escarcega-Fujigaki et al., 2011 [19] | Pro | 30 | 33 | Median = 2.3 * | Overall 81% (51/63) were unilateral * | All had follow-up of >6 months § | ||
Elderwy et al., 2014 [18] | RCT | 21 | 25 | 2 (1.5, 4) | 2.5 (1.5, 4) | All unilateral † | 1–5.5 years (range) | |
Saka et al., 2020 [20] | Retro | 24 | 25 | 2.5 (0.8–10.3) # | 2.7 (0.8–11.7) # | 63% | 80% | Median follow-up = 1.5 and 1.8 years in both groups |
Yang et al., 2020 [21] | Pro | 124 | 132 | 2.3 (0.7–11) # | 2.5 (0.8–10) # | 87% | 83% | Mean follow-up of 1 year |
Gu et al., 2021 [17] | Retro | 170 | 121 | 16.6 (8.4) | 18.4 (15.4) | All unilateral | 0.5–1 years (range) |
Author, Year | Mean (SD)/Median (IQR) Operative Duration; Minutes | Cost of Surgery | |
---|---|---|---|
LO | CO | ||
Escarcega-Fujigaki et al., 2011 [19] | 45 # | 38 # | 15% higher cost in LO |
Elderwy et al., 2014 [18] | 40 (40, 45) | 40 (35, 45) | 25% higher cost in LO |
Saka et al., 2020 [20] | U/L = 104 (51−143) B/L = 105 (78−130) | U/L = 95 (62−133) B/L = 114 (89−136) | - |
Yang et al., 2020 [21] | 62.5 (15.2) | 59.0 (13.3) | 19% higher cost in LO |
Gu et al., 2021 [17] | Age-wise operative durations were compared among the two groups * | - |
Methodological Assessment by Author 1 | ||||||
---|---|---|---|---|---|---|
Study | Reporting | External Validity | Internal Validity-Bias | Internal Validity-Confounding | Power | Total Scores |
Escarcega-Fujigaki et al., 2011 [19] | 7 | 3 | 4 | 3 | 0 | 17 |
Elderwy et al., 2014 [18] | 9 | 1 | 5 | 5 | 0 | 20 |
Saka et al., 2020 [20] | 9 | 3 | 5 | 3 | 0 | 20 |
Yang et al., 2020 [21] | 9 | 3 | 5 | 3 | 0 | 20 |
Gu et al., 2021 [17] | 9 | 3 | 5 | 3 | 0 | 20 |
Methodological Assessment by Author 2 | ||||||
Study | Reporting | External Validity | Internal Validity-Bias | Internal Validity-Confounding | Power | Total Scores |
Escarcega-Fujigaki et al., 2011 [19] | 7 | 3 | 6 | 3 | 0 | 19 |
Elderwy et al., 2014 [18] | 9 | 0 | 5 | 5 | 0 | 19 |
Saka et al., 2020 [20] | 9 | 3 | 5 | 3 | 0 | 20 |
Yang et al., 2020 [21] | 9 | 3 | 5 | 3 | 0 | 20 |
Gu et al., 2021 [17] | 9 | 3 | 5 | 4 | 0 | 21 |
Total Scores and Inter-Observer Agreement | ||||||
Study | Rater 1 | Rater 2 | Mean | Kappa Value | p-Value | |
Escarcega-Fujigaki et al., 2011 [19] | 17 | 19 | 18 | 0.926 | <0.0001 | |
Elderwy et al., 2014 [18] | 20 | 19 | 19.5 | |||
Saka et al., 2020 [20] | 20 | 20 | 20 | |||
Yang et al., 2020 [21] | 20 | 20 | 20 | |||
Gu et al., 2021 [17] | 20 | 21 | 20.5 |
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Anand, S.; Krishnan, N.; Pogorelić, Z. Utility of Laparoscopic Approach of Orchiopexy for Palpable Cryptorchidism: A Systematic Review and Meta-Analysis. Children 2021, 8, 677. https://doi.org/10.3390/children8080677
Anand S, Krishnan N, Pogorelić Z. Utility of Laparoscopic Approach of Orchiopexy for Palpable Cryptorchidism: A Systematic Review and Meta-Analysis. Children. 2021; 8(8):677. https://doi.org/10.3390/children8080677
Chicago/Turabian StyleAnand, Sachit, Nellai Krishnan, and Zenon Pogorelić. 2021. "Utility of Laparoscopic Approach of Orchiopexy for Palpable Cryptorchidism: A Systematic Review and Meta-Analysis" Children 8, no. 8: 677. https://doi.org/10.3390/children8080677