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.	曹晓明, 王东文, 梁学志, 等.经脐单孔腹腔镜技术在治疗双侧精索静脉曲张中的应用.中国综合临床, 2012, 28(3):304-306.
5.	谢敏, 徐耀庭, 顾炜, 等.单孔与三孔法腹腔镜技术治疗双侧精索静脉曲张的疗效比较.中国男科学杂志, 2012, 26(11):55-56.
6.	赵新辉.单孔与传统三孔法腹腔镜手术治疗双侧精索静脉曲张的对比研究.现代中西医结合杂志, 2012, 21(33):3691-3692.
7.	于海龙, 司良敏, 王雪冬, 等.两种腹腔镜精索静脉高位结扎术的临床效果比较.海南医学院学报, 2012, 18(3):361-367.
8.	林建功, 金讯波.经脐三孔法在腹腔镜精索静脉高位结扎术中应用的研究.泌尿外科杂志(电子版), 2009, 1(1):7-11.
9.	尹心宝, 黄健, 玄绪军, 等.经脐单孔腹腔镜精索静脉高位结扎术与传统腹腔镜手术的对比研究.中华腔镜泌尿外科杂志(电子版), 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.	王晔飞, 沈艾, 刘波, 等.经脐单孔腹腔镜与传统腹腔镜胆囊切除术安全性Meta分析.中国实用外科杂志, 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. 曹晓明, 王东文, 梁学志, 等.经脐单孔腹腔镜技术在治疗双侧精索静脉曲张中的应用.中国综合临床, 2012, 28(3):304-306.
5. 谢敏, 徐耀庭, 顾炜, 等.单孔与三孔法腹腔镜技术治疗双侧精索静脉曲张的疗效比较.中国男科学杂志, 2012, 26(11):55-56.
6. 赵新辉.单孔与传统三孔法腹腔镜手术治疗双侧精索静脉曲张的对比研究.现代中西医结合杂志, 2012, 21(33):3691-3692.
7. 于海龙, 司良敏, 王雪冬, 等.两种腹腔镜精索静脉高位结扎术的临床效果比较.海南医学院学报, 2012, 18(3):361-367.
8. 林建功, 金讯波.经脐三孔法在腹腔镜精索静脉高位结扎术中应用的研究.泌尿外科杂志(电子版), 2009, 1(1):7-11.
9. 尹心宝, 黄健, 玄绪军, 等.经脐单孔腹腔镜精索静脉高位结扎术与传统腹腔镜手术的对比研究.中华腔镜泌尿外科杂志(电子版), 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. 王晔飞, 沈艾, 刘波, 等.经脐单孔腹腔镜与传统腹腔镜胆囊切除术安全性Meta分析.中国实用外科杂志, 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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