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Conference Paper: Is staging necessary for Fowler-Stephens laparoscopic orchidopexy for intra-abdominal testis? A systematic review and meta-analysis [Oral presentation]
| Title | Is staging necessary for Fowler-Stephens laparoscopic orchidopexy for intra-abdominal testis? A systematic review and meta-analysis [Oral presentation] |
|---|---|
| Authors | |
| Issue Date | 14-Jun-2024 |
| Abstract | Introduction Intra-abdominal testis remains a challenging and controversial subset within the management of cryptorchidism. While Fowler-Stephens operation (FSO) is still being advocated as the gold standard for the treatment of this entity, there is new and conflicting evidence on the comparative outcomes between single- or two-stage laparoscopic FSO. The aim of the study is to investigate whether staging has benefits in children receiving laparoscopic FSO. Methods We searched PubMed, Medline, Embase, and Cochrane Trials databases for studies comparing single- with two-stage laparoscopic FSO in children from 1st Jan 1995 to 31st December 2023. We assessed the identified studies for quality and performed a systematic review and meta-analysis in accordance with PRISMA. The main outcome measures examined were success rate (in terms of scrotal position of testis) and testicular atrophy, which were analysed using fixed effect models. Results We included 17 eligible studies that had involved a total of 499 operated testes. The overall success rates of single- and two-stage laparoscopic FSO were 79.4% and 90.3% respectively. The overall testicular atrophy rates of single- and two-stage laparoscopic FSO were 17.3% and 11% respectively. Fixed effect model analysis showed that two-stage laparoscopic FSO is significantly superior to single-stage laparoscopic FSO in overall success rate (OR 2.57; 95% CI 1.50 to 4.39, p=0.0006) and testicular atrophy rate (OR 0.48; 95% CI 0.28 to 0.79, p=0.004). There is no heterogeneity in the reports and the funnel plot showed no publication bias. Conclusion Two-stage laparoscopic Fowler-Stephens orchidopexy remains the first choice of operation for children with high intra-abdominal testis with significantly higher success rate and lower testicular atrophy rate. |
| Persistent Identifier | http://hdl.handle.net/10722/344248 |
| DC Field | Value | Language |
|---|---|---|
| dc.contributor.author | Fung, ACH | - |
| dc.contributor.author | Tsang, JTW | - |
| dc.contributor.author | Leung, L | - |
| dc.contributor.author | Chan, IHY | - |
| dc.contributor.author | Wong, KKY | - |
| dc.date.accessioned | 2024-07-16T03:41:58Z | - |
| dc.date.available | 2024-07-16T03:41:58Z | - |
| dc.date.issued | 2024-06-14 | - |
| dc.identifier.uri | http://hdl.handle.net/10722/344248 | - |
| dc.description.abstract | <p><b>Introduction</b></p><p>Intra-abdominal testis remains a challenging and controversial subset within the management of cryptorchidism. While Fowler-Stephens operation (FSO) is still being advocated as the gold standard for the treatment of this entity, there is new and conflicting evidence on the comparative outcomes between single- or two-stage laparoscopic FSO. The aim of the study is to investigate whether staging has benefits in children receiving laparoscopic FSO.</p><p><b>Methods</b></p><p>We searched PubMed, Medline, Embase, and Cochrane Trials databases for studies comparing single- with two-stage laparoscopic FSO in children from 1st Jan 1995 to 31st December 2023. We assessed the identified studies for quality and performed a systematic review and meta-analysis in accordance with PRISMA. The main outcome measures examined were success rate (in terms of scrotal position of testis) and testicular atrophy, which were analysed using fixed effect models.</p><p><b>Results</b></p><p>We included 17 eligible studies that had involved a total of 499 operated testes. The overall success rates of single- and two-stage laparoscopic FSO were 79.4% and 90.3% respectively. The overall testicular atrophy rates of single- and two-stage laparoscopic FSO were 17.3% and 11% respectively. Fixed effect model analysis showed that two-stage laparoscopic FSO is significantly superior to single-stage laparoscopic FSO in overall success rate (OR 2.57; 95% CI 1.50 to 4.39, p=0.0006) and testicular atrophy rate (OR 0.48; 95% CI 0.28 to 0.79, p=0.004). There is no heterogeneity in the reports and the funnel plot showed no publication bias.</p><p><b>Conclusion</b></p><p>Two-stage laparoscopic Fowler-Stephens orchidopexy remains the first choice of operation for children with high intra-abdominal testis with significantly higher success rate and lower testicular atrophy rate.</p> | - |
| dc.language | eng | - |
| dc.relation.ispartof | 25th European Paediatric Surgeons' Association (EUPSA) Congress (12/06/2024-15/06/2024, , , Bologna) | - |
| dc.title | Is staging necessary for Fowler-Stephens laparoscopic orchidopexy for intra-abdominal testis? A systematic review and meta-analysis [Oral presentation] | - |
| dc.type | Conference_Paper | - |