[1]杨飞 李云飞 宁亮 贺大林.腹腔镜和开放性手术治疗非腹腔型隐睾的 meta分析[J].中华腔镜泌尿外科杂志(电子版),2014,(02):113-118.
 Yang Fei,Li Yun fei,Ning Liang,et al.Laparoscopic versus open orchiopexy for non-abdominal cryptorchidism: a meta-analysis[J].,2014,(02):113-118.
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腹腔镜和开放性手术治疗非腹腔型隐睾的 meta分析()
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中华腔镜泌尿外科杂志(电子版)[ISSN:1006-6977/CN:61-1281/TN]

卷:
期数:
2014年02期
页码:
113-118
栏目:
临床研究
出版日期:
2014-04-30

文章信息/Info

Title:
Laparoscopic versus open orchiopexy for non-abdominal cryptorchidism: a meta-analysis
作者:
杨飞 李云飞 宁亮 贺大林
710061西安,西安交通大学第一附属医院泌尿外科
Author(s):
Yang Fei Li Yun fei Ning Liang He Da lin.
Department of Urology, the First Affiliated Hospital, Xi’an Jiaotong University, Xi’an 710061, China
关键词:
隐睾腹腔镜睾丸下降固定术 meta分析
摘要:
目的分析和对比腹腔镜和开放性手术治疗非腹腔型隐睾的有效性和安全性,为临床决策提供循证医学依据。方法计算机检索 Medline、Cochrane Library、CNKI、WANFANG等国内外数据库以及对相关文献中的参考文献进行 Google scholar搜索,纳入相关随机对照试验和临床观察性研究文献。由 2名评价员独立评价文献质量和提取资料,采用 Revman5.0软件进行 Meta分析,计数资料和计量资料分别以相对危险度( OR)、加权均数差( WMD)及其 95%可信区间( CI)表示其结局效应量。结果按照预先制定的纳入和排除标准,纳入相关文献 6篇(腹腔镜睾丸固定术 LO:233例,开放睾丸固定术 OO:262例),meta分析结果显示与开放手术组比较腹腔镜手术组平均住院时间短( WMD=-2.83, 95%CI =[-4.15,-1.51],P<0.0001),术后并发症少( OR=0.21,95%CI =[0.10,0.43],P<0.0001),二次手术率低( OR=0.22,95%CI =[0.05,0.88],P =0.03),但二者在手术时间( WMD=-3.77,95%CI =[-10.49,2.94], P =0.27)和术中出血量( WMD=-2.08,95%CI=[-4.33,0.16],P =0.07)没有统计学差异。结论腹腔镜手术治疗非腹腔型隐睾在平均住院日、术后并发症及二次手术率方面均优于开放手术;但考虑到纳入研究的文献质量不高且存在发表偏倚,故尚需大规模多中心的临床随机对照试验提供最佳循证医学依据。

参考文献/References:

[1] 朱友华,孙颖浩,徐丹枫.泌尿外科医师手册 .上海 :第二军医大学出版社, 2006, 106-107.
[2] 鲍俏,张文.小儿隐睾的诊断标准和治疗方案[J].实用儿科临床杂志, 2012, 27(23): 1847-1848.
[3] Kollin C, Hesser U, Ritzen EM, et al. Testicular growth from birth to two years of age, and the effect of orchidopexy at age nine months: a randomized, controlled study [J]. Acta paediatrica, 2006, 95(3): 318-324.
[4] 叶章群 .睾丸下降异常 .见:陈孝平主编 .外科学 (下册 ).北京 :人民卫生出版社, 2005, 816.
[5] 甘贤优,郑新民,李新宁.腹腔镜与开放手术治疗非腹腔型隐睾的比较研究(附 168例分析)[J].微创医学, 2008, 3(2): 99-100.
[6] 郑健 ,林涛 ,魏光辉 ,等.腹腔镜下治疗非腹腔型隐睾的临床研究[J].第三军医大学学报, 2009, 31(20): 2031-2033.
[7] 汪自力 ,易炜 ,陈刚 ,等.腹腔镜手术与传统开放手术治疗非腹腔型隐睾临床疗效的对比研究[J].腹腔镜外科杂志, 2011, 16(1): 53-54.
[8] 任兰君,宁静,姜良富.腹腔镜与开放手术治疗低年龄患儿非腹腔型隐睾的比较研究[J].中国医药指南, 2012, 10(5): 185-186.
[9] 王峰 .腹腔镜手术与开发性手术治疗小儿隐睾的疗效比较[J].北方药学, 2013, 10(4): 87.
[10] 叶安.腹腔镜手术治疗 103例非腹腔型隐睾 [J].临床和实验医学杂志, 2011, 10(3): 187-188.
[14] Guo J, Liang ZL, Zhang HY, et al. Laparoscopic versus open学杂志, 2011, 10(3): 187-188.
[11] Cortesi N, Ferrari P, Zambarda E, et al. Diagnosis of bilateral abdominal cryptorchidism by laparoscopy[J]. Endoscopy, 1976, 8(1): 33-34.
[12] Chang B, Palmer LS, Franco I. Laparoscopic orchidopexy: a review of a large clinical series[J]. BJU Int, 2001, 87(6): 490-493.
[13] Jordan GH, Robey EL, Winslow BH. Laparoscopic surgical management of the abdominal/transinguinal undescended testicle [J]. J Endourol, 1992, 6(2): 159-163.
[14] Guo J, Liang ZL, Zhang HY, et al. Laparoscopic versus open orchiopexy for non-palpable undescended testes in children: a systemic review and meta-analysis [J]. Pediatr Surg Int, 2011, 27 (9): 943-952.
[15] Baker LA, Docimo SG, Surer I, et al. A multi-institutional analysis of laparoscopic orchidopexy [J]. BJU Int, 2001, 87 (6):484-489.

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备注/Memo

备注/Memo:
通讯作者:贺大林,Email:hedl@mail.xjtu.edu.cn
更新日期/Last Update: 2014-04-25