Single scrotal incision orchiopexy versus the inguinal approach in children with palpable undescended testis: a systematic review and meta-analysis

Feng, Shaoguang; Yang, Huajun; Li, Xiang; Yang, Junjia; Zhang, Jie; Wang, Aihe; Lai, Xin‐He; Qiu, Yuhui

doi:10.1007/s00383-016-3956-4

Cited by 33 publications

(38 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…So far, testicular atrophy has not been found in 773 patients in this group. Secondly, open surgery requires separate the inguinal canal, which not only destroys the anatomical structure of the inguinal canal, but also needs to cut the intra-abdominal oblique muscle and the transverse abdominis muscle at the inner ring for a higher position of the inguinal typical cryptorchidism, which would be prone to occur wound infection, bleeding, and even testicular retraction; according to the literature, the wound infection rate of open inguinal orchiopexy is 1.9-2.5% [2,10]. At last, the most important is trans-inguinal orchiopexy unable to detect a contralateral occult hernia or patent processus vaginalis, cryptorchidism associate with a contralateral patent processus reach up to 33-40% [7,9], while preoperative color Doppler ultrasound examination only discovers about 20% [11].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic orchiopexy of palpable undescended testes_ experience of a single tertiary institution with over 773 cases

You

Chen

et al. 2020

BMC Pediatr

View full text Add to dashboard Cite

Background: Discuss the superiority of laparoscopic orchiopexy in the treatment of inguinal palpable undescended testes. Methods: Inclusion criteria: Preoperative examination and color Doppler ultrasound examination confirmed that the testes were located in the inguinal canal and could not be pulled into the scrotum, except for retractive and ectopic testes. The surgical steps were depicted as follow. The retroperitoneal wall was carved by ultrasonic scalpels, separates the spermatic vessels closed to the inferior pole of the kidney if necessary, dissects the peritoneum of vas deferens, cuts the testicular gubernaculum, and pulls back the testicle into the abdominal cavity. Besides, protect the vas deferens, and descend the testes to the scrotum and fix them without tension. Results: There were 773 patients with 869 inguinal undescended palpable testes, 218 cases on the left side, 459 cases on the right side and 96 cases with bilateral undescended testes, whose age ranged from 6 months to 8 years, with an average of 20 months. All testes were successfully operated, no converted to open surgery. The average operation time was (34.8 ± 5.4) min. There were 692 testes have an ipsilateral patent processus vaginalis (89.5%); In 677 cases of unilateral cryptorchidism, 233 cases (34.4%) have a contralateral patent processus vaginalis, and laparoscopic percutaneous extraperitoneal closure the hernia sac carry out during the surgery. There was no subcutaneous emphysema during the operation, no vomiting, no abdominal distension, no wound bleeding and obvious pain after surgery, especially wound infection is rarely. Doppler ultrasound was evaluated regularly after surgery. The patients were followed up for 6 to 18 months. All the testes were located in the scrotum without testicular retraction and atrophy. No inguinal hernia or hydrocele was found in follow-up examination.Conclusion: Laparoscopic orchiopexy manage inguinal palpable cryptorchidism is safe and effective, and there are obvious minimally invasive advantages. Furthermore, It could discover a contralateral patent processus vaginalis, and treat at the same time, which avoid the occurrence of metachronous inguinal hernia.

show abstract

Section: Discussionmentioning

confidence: 99%

Laparoscopic orchiopexy of palpable undescended testes_ experience of a single tertiary institution with over 773 cases

You

Chen

et al. 2020

BMC Pediatr

View full text Add to dashboard Cite

show abstract

“…Zudem kann der Eingriff in einer deutlich kürzeren Operationszeit durchgeführt werden. In dem systematischen Review und der Meta-Analyse von Feng et al aus 2016 erfolgte die Operation über den skrotalen Zugang zwischen 8 und 14 Minuten schneller als mittels der inguinalen Inzision [5]. Aufgrund der fehlenden inguinalen Inzision mit einem Zugang über die gefältelte Skrotalhaut zeigen sich außerdem weniger Narben mit einem deutlich verbesserten kosmetischen Ergebnis [6].…”

Section: Introductionunclassified

“…Auch bezüglich der Inzidenz von Hernien oder Hydrozelen fand sich kein signifikanter Unterschied. Abschließend fassten die Autoren zusammen, dass es sich bei der skrotalen Orchidofunikolyse somit um ein geeignetes, sicheres und effizientes Verfahren im Vergleich zur inguinalen Inzision bei deutlich verkürzter Operationszeit mit geringer Morbidität handelt [5].…”

Section: Introductionunclassified

Operative Zugangswege beim Gleithoden und tiefen Leistenhoden – skrotaler Zugang

2019

View full text Add to dashboard Cite

ZusammenfassungDer Hodenhochstand ist die häufigste urogenitale Erkrankung im Kindesalter. Weiterhin gilt der inguinale Zugangsweg für die Orchidofunikolyse als operative Methode der Wahl. Eine Vielzahl von Studien konnten in den letzten zwei Jahrzehnten zeigen, dass die skrotale Orchidofunikolyse aufgrund der geringen Invasivität und einer damit verbundenen reduzierten Morbidität bei deutlich kürzerer Operationszeit und einem guten kosmetischen Ergebnis bei gleichem operativen Behandlungsergebnis eine gute Alternative beim Gleit- und tiefen Leistenhoden darstellt.

show abstract

“…So far, testicular atrophy has not been found in 773 patients in this group. Secondly, open surgery requires separate the inguinal canal, which not only destroys the anatomical structure of the inguinal canal, but also needs to cut the intra-abdominal oblique muscle and the transverse abdominis muscle at the inner ring for a higher position of the inguinal typical cryptorchidism, which would be prone to occur wound infection, bleeding, and even testicular retraction; according to the literature, the wound infection rate of open inguinal orchiopexy is 1.9%-2.5% [2,10].At last, the most important is trans-inguinal orchiopexy unable to detect a contralateral occult hernia or patent processus vaginalis, cryptorchidism associate with a contralateral patent processus reach up to 33%-40% [7,9], while preoperative color Doppler ultrasound examination only discovers about 20% [11]. A prospective study in Japan indicated that the diameter of the contralateral processus vaginalis can be developed into symptomatic inguinal hernia with a diameter of >2 mm, with specificity and sensitivity of 81.8% and 71.3%, respectively [12].…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic orchiopexy of palpable undescended testes_ experience of a single tertiary institution with over 773 cases

You

Chen

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Discuss the superiority of laparoscopic orchiopexy in the treatment of inguinal palpable undescended testes. Methods Inclusion criteria: Preoperative examination and color Doppler ultrasound examination confirmed that the testes were located in the inguinal canal and could not be pulled into the scrotum, except for retractive and ectopic testes. The surgical steps were depicted as follow. The retroperitoneal wall was carved by ultrasonic scalpels, separates the spermatic vessels closed to the inferior pole of the kidney if necessary, dissects the peritoneum of vas deferens, cuts the testicular gubernaculum, and pulls back the testicle into the abdominal cavity. Besides, protect the vas deferens, and descend the testes to the scrotum and fix them without tension. Results There were 773 patients with 869 inguinal undescended palpable testes, 218 cases on the left side, 459 cases on the right side and 96 cases with bilateral undescended testes, whose age ranged from 6 months to 8 years, with an average of 20 months. All testes were successfully operated, no converted to open surgery. The average operation time was (34.8 ± 5.4) min. There were 692 testes have an ipsilateral patent processus vaginalis (89.5%); In 677 cases of unilateral cryptorchidism, 233 cases (34.4%) have a contralateral patent processus vaginalis, and laparoscopic percutaneous extraperitoneal closure the hernia sac carry out during the surgery. There was no subcutaneous emphysema during the operation, no vomiting, no abdominal distension, no wound bleeding and obvious pain after surgery, especially wound infection is rarely. Doppler ultrasound was evaluated regularly after surgery. The patients were followed up for 6 to 18 months. All the testes were located in the scrotum without testicular retraction and atrophy. No inguinal hernia or hydrocele was found in follow-up examination. Conclusion Laparoscopic orchiopexy manage inguinal palpable cryptorchidism is safe and effective, and there are obvious minimally invasive advantages. Furthermore, It could discover a contralateral patent processus vaginalis, and treat at the same time, which avoid the occurrence of metachronous inguinal hernia.

show abstract

Single scrotal incision orchiopexy versus the inguinal approach in children with palpable undescended testis: a systematic review and meta-analysis

Cited by 33 publications

References 17 publications

Laparoscopic orchiopexy of palpable undescended testes_ experience of a single tertiary institution with over 773 cases

Laparoscopic orchiopexy of palpable undescended testes_ experience of a single tertiary institution with over 773 cases

Operative Zugangswege beim Gleithoden und tiefen Leistenhoden – skrotaler Zugang

Laparoscopic orchiopexy of palpable undescended testes_ experience of a single tertiary institution with over 773 cases

Contact Info

Product

Resources

About