Therapeutic Effects Of Open Versus Laparoscopic Technique On Adult Varicocele: A Meta Analysis

OBJECTIVE:Systematic evaluation of the traditional open surgery and laparoscopic surgery forvaricocele treatment, choice for the majority of clinicians to provide safe and effectivesurgical basis.Methods:First, used of the electronic retrieval literature beginning of the seizure, there areelectronic access to databases Pubmed/Medline database (1990.1-2011.12), OVID(1990.1-2011.12), EMBASE (1990.1-2011.12), Chinese Biomedical Database(CBM,1990.1-2011.12)China Academic Journal (CNKI:1990.1-2011.12), ChineseEvidence-Based Medicine/Cochrane Center database (CEBM\CCD), CochraneLibrary; followed by manual retrieval of recent "Journal of Urology","Urology" andother relevant literaturethe magazine.Collected all of the surgical treatment ofvaricocele, and is the randomized controlled trials (RCTs) of the relevant researchliterature.All documents strictly for initial screening, access to primary literature afterthe text of the Cochrane Collaboration and the use of risk assessment toolsrecommended by the bias of the trial evaluation.Literature data were extractedindependently by two researchers, using RevMan5.1Meta-analysis software.RESULTSR:After a careful search and exclusion, the final five RCTs met the inclusion criteriaincluded patients with710cases.Meta-analysis results showed:In five studies in three trials open and laparoscopic treatment can be extractedvaricocele operation time of the relevant data, statistical analysis software by RevMan5.1combined data was WMD=5.57,95%CI=(6.99,4.16), P <0.00001, Z=7.72, that laparoscopic surgery varicocele surgery time shorter than open surgery.In five studies in three trials open and laparoscopic treatment can be extractedvaricocele-related hospitalization data, statistical analysis software by RevMan5.1combined data was WMD=2.99,95%CI=(3.30,2.67), P <0.00001, Z=18.59, thatlaparoscopic surgery of varicocele on the length of stay shorter than open surgery.In five studies there are two tests can be extracted open and laparoscopic treatment ofvaricocele recurrence rate of the relevant data, statistical analysis software byRevMan5.1combined data was OR=1.55,95%CI=(0.88,2.75), P=0.13, Z=1.51,that open and laparoscopic treatment of varicocele recurrence rate of the differencewas not statistically significant.In five studies there are two tests can be extracted open and laparoscopic treatment ofvaricocele incidence of postoperative hydrocele data, statistical analysis software byRevMan5.1combined data was OR=1.76,95%CI=(0.79,3.91), P=0.16, Z=1.39,that open and laparoscopic treatment of varicocele on the incidence of postoperativehydrocele was no significant difference.Conclusion:These results suggest that: open and laparoscopic surgery, two procedures in theincidence of postoperative hydrocele and recurrence rates on the two indicators wereno significant differences.The operative time and hospital stay in two indicators issuperior to laparoscopic surgical open surgery.Laparoscopic treatment of varicocelecompared with open surgery is more effective.However, because of publication bias,selection bias may be, we look forward to higher quality studies appear abovefindings provide more reliable evidence.