Meta-analysis Of The Effeciveness Of Microscopic Surgery And Laparoscopic Sugery In Treatment Of Varicoele

Objective: At present the comparison of surgical operation for treatment ofvaricocele, mainly between open surgery and laparoscopic surgery, microscopicsurgery and laparoscopic surgery were relatively rare. In this study, evaluateefficacy of surgical methods under the microscopic and laparoscopic whichwere used for treatment of varicocele to choose a safe and effective surgicalprocedures for clinicians.Methods: Search of PubMed, EMBASE, Cochrane Library, ChineseEvidence-Based Medicine/Cochrane Center database (CEBM/CCD), CNKI,Wanfang Data from1996to March2014, Collect literatures met the inclusioncriteria and extracted data include the frequency of postoperative recurrence,pregnancy, hydrocele and edema of scrotum，merge effect size expressed in oddsratio and95%confidence interval. Two investigators in charge of evaluating ofmethodological quality of included studies and literature data extracted. Metaforanalysis software package of R language, bilateral p <0.05suggest difference isstatistically significant.Results: There were12articles met in the inclusion criteria whichincluded patients with a total of1240cases,596cases in microscopic group and 644cases in laparoscopic group. After analyzing with R language: Microscopicgroup treatment of varicocele recurrence rate was lower than the laparoscopicgroup (OR=0.28,95%CI=0.16-0.49, P <0.001); edema of scrotum rate aftermicroscopic varicocele surgery was lower than the laparoscopic group (OR=0.31,95%CI=0.13-0.73, P=0.007); microscopic treatment of varicocele waslower with the incidence of postoperative hydrocele than laparoscopic group(OR=0.23,95%CI=0.08-0.70, P=0.009); There was no significantdifference in postoperative pregnancy rate between the two group (P=0.224).Conclusion: This study showed that postoperative recurrence rate,incidence of hydrocele and edema of scrotum in microscopic surgery waslower than in laparoscopic surgery. There was no significant difference inpostoperative pregnancy rate between microscopic surgery and laparoscopicsurgery.Overall, we consider that microsurgical for varicocele get theadvantage over laparoscopic surgery. Areas where conditions permit can carryout microscopic surgery priority.