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Article: Comparative outcomes of single-stage versus two-stage laparoscopic Fowler-Stephens orchidopexy: A systematic review and meta-analysis
Title | Comparative outcomes of single-stage versus two-stage laparoscopic Fowler-Stephens orchidopexy: A systematic review and meta-analysis |
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Authors | |
Issue Date | 1-Feb-2025 |
Publisher | Georg Thieme Verlag / Thieme Publishing |
Citation | European Journal of Pediatric Surgery, 2025, v. 35, n. 1, p. 28-35 How to Cite? |
Abstract | Introduction: Intra-abdominal testis (IAT) remains a challenging and controversial subset within the management of cryptorchidism. While Fowler-Stephens orchidopexy (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 (LFSO). The aim of the study is to investigate whether staging has benefits in children receiving LFSO. Methods: We searched the PubMed, Medline, Embase, and Cochrane Trials databases for studies comparing single- with two-stage LFSO in children from January 1, 1995 to December 31, 2023. We assessed the identified studies for quality and performed a systematic review and meta-analysis in accordance with the Preferred Reporting of Systematic Reviews and Meta-Analyses. The main outcome measures examined were success rate (in terms of the scrotal position of the testis) and testicular atrophy, which were analyzed using fixed effect models. Results: We included 17 eligible studies that involved a total of 499 operated testes. The overall success rates of single- and two-stage LFSO were 79.4 and 90.3%, respectively. The overall testicular atrophy rates of single- and two-stage LFSO were 17.3 and 11%, respectively. Fixed effect model analysis showed that two-stage LFSO is significantly superior to single-stage LFSO in overall success rate (odds ratio [OR: 2.57]; 95% confidence interval [CI]: 1.50-4.39, p = 0.0006) and testicular atrophy rate (OR: 0.48; 95% CI: 0.28-0.79, p = 0.004). There is no heterogeneity in the reports, and the funnel plot showed no publication bias. Conclusions: Two-stage LFSO remains the first choice of operation for children with a high IAT, with a significantly higher success rate and a lower testicular atrophy rate. |
Persistent Identifier | http://hdl.handle.net/10722/353901 |
ISSN | 2023 Impact Factor: 1.5 2023 SCImago Journal Rankings: 0.585 |
DC Field | Value | Language |
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dc.contributor.author | Fung, Adrian Chi Heng | - |
dc.contributor.author | Tsang, Jaime Tze Wing | - |
dc.contributor.author | Leung, Ling | - |
dc.contributor.author | Chan, Ivy Hau Yee | - |
dc.contributor.author | Wong, Kenneth Kak Yuen | - |
dc.date.accessioned | 2025-01-28T00:35:44Z | - |
dc.date.available | 2025-01-28T00:35:44Z | - |
dc.date.issued | 2025-02-01 | - |
dc.identifier.citation | European Journal of Pediatric Surgery, 2025, v. 35, n. 1, p. 28-35 | - |
dc.identifier.issn | 0939-7248 | - |
dc.identifier.uri | http://hdl.handle.net/10722/353901 | - |
dc.description.abstract | <p><strong>Introduction: </strong>Intra-abdominal testis (IAT) remains a challenging and controversial subset within the management of cryptorchidism. While Fowler-Stephens orchidopexy (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 (LFSO). The aim of the study is to investigate whether staging has benefits in children receiving LFSO.</p><p><strong>Methods: </strong>We searched the PubMed, Medline, Embase, and Cochrane Trials databases for studies comparing single- with two-stage LFSO in children from January 1, 1995 to December 31, 2023. We assessed the identified studies for quality and performed a systematic review and meta-analysis in accordance with the Preferred Reporting of Systematic Reviews and Meta-Analyses. The main outcome measures examined were success rate (in terms of the scrotal position of the testis) and testicular atrophy, which were analyzed using fixed effect models.</p><p><strong>Results: </strong>We included 17 eligible studies that involved a total of 499 operated testes. The overall success rates of single- and two-stage LFSO were 79.4 and 90.3%, respectively. The overall testicular atrophy rates of single- and two-stage LFSO were 17.3 and 11%, respectively. Fixed effect model analysis showed that two-stage LFSO is significantly superior to single-stage LFSO in overall success rate (odds ratio [OR: 2.57]; 95% confidence interval [CI]: 1.50-4.39, <em>p</em> = 0.0006) and testicular atrophy rate (OR: 0.48; 95% CI: 0.28-0.79, <em>p</em> = 0.004). There is no heterogeneity in the reports, and the funnel plot showed no publication bias.</p><p><strong>Conclusions: </strong>Two-stage LFSO remains the first choice of operation for children with a high IAT, with a significantly higher success rate and a lower testicular atrophy rate.</p> | - |
dc.language | eng | - |
dc.publisher | Georg Thieme Verlag / Thieme Publishing | - |
dc.relation.ispartof | European Journal of Pediatric Surgery | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.title | Comparative outcomes of single-stage versus two-stage laparoscopic Fowler-Stephens orchidopexy: A systematic review and meta-analysis | - |
dc.type | Article | - |
dc.description.nature | preprint | - |
dc.identifier.doi | 10.1055/a-2375-9784 | - |
dc.identifier.volume | 35 | - |
dc.identifier.issue | 1 | - |
dc.identifier.spage | 28 | - |
dc.identifier.epage | 35 | - |
dc.identifier.eissn | 1439-359X | - |
dc.identifier.issnl | 0939-7248 | - |