Effectiveness and Safety of Laparoendoscopic Single-site Surgery for Varicocele: A Meta-Analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 LUCheng-zhou ^1,2,3,4 , XIAOEr-long ^1,2,3,4 ,  WANGZhi-ping ^1,2,3,4

1. Department of Urology, The Second Hospital of Lanzhou University, Lanzhou 730030, China;
2. Institute of Urology, The Second Hospital of Lanzhou University, Lanzhou 730030, China;
3. Gansu Nephro-Urological Clinical Center, Lanzhou 730030, China;
4. Key Laboratory of Urological Diseases of in Gansu Province, Lanzhou 730030, China;

Corresponding?author：

WANGZhi-ping, Email: erywzp@lzu.edu.cn

Keywords：

Laparoendoscopic single-site surgery; Varicocelectomy; Systematic review; Meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.20140011

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Objective To systematically review the effectiveness and safety of laparoendoscopic single-site surgery (LESS) for varicocele. Methods Such databases as The Cochrane Library, MEDLINE, EMbase, CBM, CNKI, and WanFang Data were electronically searched for studies about LESS and traditional laparoscopy for varicocele till March 1st, 2013. According to the inclusion and exclusion criteria, literature was screened, data were extracted, and the methodological quality of included studies was also assessed. Then, meta-analysis was performed using RevMan 5.1 software. Results Seven RCTs involving 452 cases were included. The results of meta-analysis showed that, there was no significant difference between LESS and traditional laparoscopy for varicocele on post-operational complications (RR=0.57, 95%CI 0.26 to 1.27, P=0.17), duration of hospital stay (MD=-0.30, 95%CI-0.87 to 0.26, P=0.30), improvement of semen parameters, and blood loss. However, LESS had longer duration of operation (MD=11.26, 95%CI 3.62 to 18.90, P=0.004). Conclusion The effectiveness and safety of LESS and traditional laparoscopy for varicocele are similar, and LESS could achieve more beautiful and natural effects which has longer surgery time on account of non-proficiency in surgery and equipment. Due to the limited quantity and quality of the included studies, the above conclusion requires to be proved by more high quality randomized controlled trials.

Citation： LUCheng-zhou, XIAOEr-long, WANGZhi-ping. Effectiveness and Safety of Laparoendoscopic Single-site Surgery for Varicocele: A Meta-Analysis. Chinese Journal of Evidence-Based Medicine, 2014, 14(1): 59-64. doi: 10.7507/1672-2531.20140011 Copy

1.	?Borruto FA, Impellizzeri P, Antonuccio P, et al. Laparoscopic vs open varicocelectomy in children and adolescents:review of the recent literature and meta-analysis. J Pediatr Surg, 2010, 45(12):2464-2469.
2.	Ding H, Tian J, Du W, et al. Open non-microsurgical, laparoscopic or open microsurgical varicocelectomy for male infertility:a meta-analysis of randomized controlled trials. BJU Int, 2012, 110(10):1536-1542.
3.	Autorino R, Cadeddu JA, Desai MM, et al. Laparoendoscopic single-site and natural orifice transluminal endoscopic surgery in urology:a critical analysis of the literature. Eur Urol, 2011, 59(1):26-45.
4.	曹曉明, 王東文, 梁學志, 等.經臍單孔腹腔鏡技術在治療雙側精索靜脈曲張中的應用.中國綜合臨床, 2012, 28(3):304-306.
5.	謝敏, 徐耀庭, 顧煒, 等.單孔與三孔法腹腔鏡技術治療雙側精索靜脈曲張的療效比較.中國男科學雜志, 2012, 26(11):55-56.
6.	趙新輝.單孔與傳統三孔法腹腔鏡手術治療雙側精索靜脈曲張的對比研究.現代中西醫結合雜志, 2012, 21(33):3691-3692.
7.	于海龍, 司良敏, 王雪冬, 等.兩種腹腔鏡精索靜脈高位結扎術的臨床效果比較.海南醫學院學報, 2012, 18(3):361-367.
8.	林建功, 金訊波.經臍三孔法在腹腔鏡精索靜脈高位結扎術中應用的研究.泌尿外科雜志(電子版), 2009, 1(1):7-11.
9.	尹心寶, 黃健, 玄緒軍, 等.經臍單孔腹腔鏡精索靜脈高位結扎術與傳統腹腔鏡手術的對比研究.中華腔鏡泌尿外科雜志(電子版), 2010, 4(5):352-356.
10.	Lee SW, Lee JY, Kim KH, et al. Laparoendoscopic single-site surgery versus conventional laparoscopic varicocele ligation in men with palpable varicocele:a randomized, clinical study. Surg Endosc, 2012, 26(4):1056-1062.
11.	Lee JY, Lee SW. Concomitant laparoendoscopic single-site surgery for ureterolithotomy and contralateral renal cyst marsupialization. Korean J Urol, 2011, 52(1):64-67.
12.	Kocvara R, Dvoracek J, Sedlacek J, et al. Lymphatic sparing laparoscopic varicocelectomy:a microsurgical repair. J Urol, 2005, 173(5):1751-1754.
13.	王曄飛, 沈艾, 劉波, 等.經臍單孔腹腔鏡與傳統腹腔鏡膽囊切除術安全性Meta分析.中國實用外科雜志, 2012, 32(12):1031-1036.

1. ?Borruto FA, Impellizzeri P, Antonuccio P, et al. Laparoscopic vs open varicocelectomy in children and adolescents:review of the recent literature and meta-analysis. J Pediatr Surg, 2010, 45(12):2464-2469.
2. Ding H, Tian J, Du W, et al. Open non-microsurgical, laparoscopic or open microsurgical varicocelectomy for male infertility:a meta-analysis of randomized controlled trials. BJU Int, 2012, 110(10):1536-1542.
3. Autorino R, Cadeddu JA, Desai MM, et al. Laparoendoscopic single-site and natural orifice transluminal endoscopic surgery in urology:a critical analysis of the literature. Eur Urol, 2011, 59(1):26-45.
4. 曹曉明, 王東文, 梁學志, 等.經臍單孔腹腔鏡技術在治療雙側精索靜脈曲張中的應用.中國綜合臨床, 2012, 28(3):304-306.
5. 謝敏, 徐耀庭, 顧煒, 等.單孔與三孔法腹腔鏡技術治療雙側精索靜脈曲張的療效比較.中國男科學雜志, 2012, 26(11):55-56.
6. 趙新輝.單孔與傳統三孔法腹腔鏡手術治療雙側精索靜脈曲張的對比研究.現代中西醫結合雜志, 2012, 21(33):3691-3692.
7. 于海龍, 司良敏, 王雪冬, 等.兩種腹腔鏡精索靜脈高位結扎術的臨床效果比較.海南醫學院學報, 2012, 18(3):361-367.
8. 林建功, 金訊波.經臍三孔法在腹腔鏡精索靜脈高位結扎術中應用的研究.泌尿外科雜志(電子版), 2009, 1(1):7-11.
9. 尹心寶, 黃健, 玄緒軍, 等.經臍單孔腹腔鏡精索靜脈高位結扎術與傳統腹腔鏡手術的對比研究.中華腔鏡泌尿外科雜志(電子版), 2010, 4(5):352-356.
10. Lee SW, Lee JY, Kim KH, et al. Laparoendoscopic single-site surgery versus conventional laparoscopic varicocele ligation in men with palpable varicocele:a randomized, clinical study. Surg Endosc, 2012, 26(4):1056-1062.
11. Lee JY, Lee SW. Concomitant laparoendoscopic single-site surgery for ureterolithotomy and contralateral renal cyst marsupialization. Korean J Urol, 2011, 52(1):64-67.
12. Kocvara R, Dvoracek J, Sedlacek J, et al. Lymphatic sparing laparoscopic varicocelectomy:a microsurgical repair. J Urol, 2005, 173(5):1751-1754.
13. 王曄飛, 沈艾, 劉波, 等.經臍單孔腹腔鏡與傳統腹腔鏡膽囊切除術安全性Meta分析.中國實用外科雜志, 2012, 32(12):1031-1036.

Chinese Journal of Evidence-Based Medicine

Effectiveness and Safety of Laparoendoscopic Single-site Surgery for Varicocele: A Meta-Analysis

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