单孔与传统腹腔镜治疗精索静脉曲张随机对照研究的Meta分析

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摘要 目的:基于随机对照试验,评价单孔腹腔镜和传统腹腔镜治疗精索静脉曲张的疗效。方法:通过电子检索PubMed、Embase、Cochrone图书馆、中国生物医学文献数据库(CBM)、中国知网数据库(CNKI),并根据制定的纳入和排除标准对文章进行筛选,采用Cochrone系统评价手册推荐的随机对照试验的评估方法对文章的偏倚风险进行评估,通过RevMan 5.2软件对各项观察指标(手术时间、术中出血量、24 h疼痛评分、住院时间、住院费用、精子数量、精子活力、精子形态)进行统计学分析。结果:共12项研究纳入到本次的Meta分析中(单孔组325例,传统组326例)。单孔腹腔镜组的手术时间长于传统腹腔镜组(SMD:0.70 [0.05,1.34];P=0.03);而单孔腹腔镜组的术中出血量(SMD:-0.26 [-0.49,-0.03];P=0.0.02)及24 h疼痛评分(SMD:-1.15 [-2.10,-0.20];P=0.02)则低于传统腹腔镜组;两组间的住院时间(SMD:-0.37 [-0.76,0.03];P=0.07)、住院费用(SMD:0.02[-0.64,0.68];P=0.94)、精子数量(SMD:-0.24 [-0.49,0.01];P=0.06)、精子活力(SMD:0.06 [-0.94,1.05];P=0.91)、精子形态(SMD:0.48 [-0.08,1.03];P=0.10)没有明显差异。结论:和传统腹腔镜治疗精索静脉曲张相比较,单孔腹腔镜是一种安全、有效、创伤更小、美观效果更佳的手术方式。

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	林斌
	朱景振
	李龙坤

关键词 ：单孔腹腔镜, 传统腹腔镜, 精索静脉曲张, Meta分析

Abstract：Objective: To compare the effects of single-incision laparoscope and conventional laparoscope in the treatment of varicocele based on randomized controlled trials. Methods: By searching PubMed, Embase, Cochrone liberary, the Chinese biomedical literature database (CBM) and China National Knowledge Infrastructure (CNKI), all of the eligible articles which conformed to the inclusion and exclusion criteria were harvested, and the risk of bias was evaluated according the Cochrone's methods. The observation indexes (operating time, bleeding, pain scores, length of hospital stay, hospital costs, sperm counts, sperm motility, sperm morphology) were analyzed using the software of RevMan 5.2. Results: A total of 12 articles (325 cases of single-incision group and 326 cases of conventional group) were analyzed in our study. The operating time (SMD: 0.70 [0.05, 1.34]) in single-incision group was significantly longer than in conventional group. The bleeding (SMD: -0.26 [-0.49, -0.03]) and the pain scores (SMD: -1.15 [-2.10, -0.20]) in single-incision group were significantly lower than in conventional group. However, there were no significant differences in the length of hospital stay (SMD: -0.37 [-0.76, 0.03]), the hospital costs (SMD: 0.02[-0.64, 0.68]), the sperm counts (SMD: -0.24 [-0.49, 0.01]), the sperm motility (SMD: 0.06 [-0.94, 1.05]), and the sperm morphology (SMD: 0.48 [-0.08, 1.03]) between single-incision group and conventional group. Conclusions: As compared with conventional laparoscope, single-incision laparoscope is a safe and effective minimally invasive surgical alternative for varicocele.

Key words： single-incision laparoscope conventional laparoscope varicocele meta-analysis

收稿日期: 2016-07-05

ZTFLH:

R697.24

通讯作者: 林斌,762556050@qq.com

引用本文:

林斌,朱景振,李龙坤. 单孔与传统腹腔镜治疗精索静脉曲张随机对照研究的Meta分析[J]. 微创泌尿外科杂志, 2016, 5(6): 336-342.
Lin Bin，Zhu Jingzhen，Li Longkun. Effects of single-incision laparoscope and conventional laparoscope in the treatment of varicocele: a meta-analysis of randomized contolled trials. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2016, 5(6): 336-342.

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http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/abstract/abstract1224.shtml 或 http://journal20.magtechjournal.com/Jwk_zgmnwk/CN/Y2016/V5/I6/336

[1] Witt MA, Lipshultz LI. Varicocele: a progressive or static lesion? Urology, 1993,42(5):541-543.
[2] Naughton CK, Nangia AK, Agarwal A. Pathophysiology of varicoceles in male infertility. Hum Reprod Update, 2001,7(5):473-481.
[3] French DB, Desai NR, Agarwal A. Varicocele repair: does it still have a role in infertility treatment? Curr Opin Obstet Gynecol, 2008,20(3):269-274.
[4] Baazeem A, Belzile E, Ciampi A, et al. Varicocele and male factor infertility treatment: A new meta-analysis and review of the role of varicocele repair. Eur Urol, 2011,60(4):796-808.
[5] Bansal D, Riachy E, Defoor WR Jr, et al. Pediatric varicocelectomy: A comparative study of conventional laparoscopic and laparoendoscopic single-site approaches. J Endourol, 2014,28(5):513-516.
[6] Zampieri N, Zuin V, Corroppolo M, et al. Varicocele and adolescents: Semen quality after 2 different laparoscopic procedures. J Androl, 2007,28(5):727-733.
[7] Kaouk JH, Palmer JS. Single-port laparoscopic surgery: Initial experience in children for varicocelectomy. BJU Int, 2008,102(1):97-99.
[8] Lee SW, Lee JY, Kim KH, et al. Laparoendoscopic single-site surgery versus conventional laparoscopic varicocele ligation in men with palpable varicocele: A randomized, clinical study. Surg Endosc, 2012,26(4):1056-1062.
[9] Wang J, Xue B, Shan YX, et al. Laparoendoscopic single-site surgery with a single channel versus conventional laparoscopic varicocele ligation: A prospective randomized study. J Endourol, 2014,28(2):159-164.
[10] Youssef T, Abdalla E. Single incision transumbilical laparoscopic varicocelectomy versus the conventional laparoscopic technique: A randomized clinical study. Int J Surg, 2015,18:178-183.
[11] 尹心宝,黄健,玄绪军,等.经脐单孔腹腔镜精索静脉高位结扎术与传统腹腔镜手术的对比研究.中华腔镜泌尿外科杂志,2010,4(5):352-356.
[12] 曹晓明,王东文,梁学志,等.经脐单孔腹腔镜技术在治疗双侧精索静脉曲张中的应用.中国综合临床,2012,28(3):304-306.
[13] 李梅,黎明,蔡小萱,等.自制套环的单孔腹腔镜精索静脉高位结扎术临床观察及护理.中国现代药物应用,2015,9(12):195-197.
[14] 李梅,陈慧娴,蔡小萱,等.自制通道的单孔腹腔镜精索静脉高位结扎术临床观察及护理.吉林医学,2015,36(16):3671-3672.
[15] 谢敏,徐耀庭,顾炜,等.单孔与三孔法腹腔镜技术治疗双侧精索静脉曲张的疗效比较.中国男科学杂志,2012,26(11):55-56.
[16] 赵学良,马锐,冯浩.经脐单孔腹腔镜与传统腹腔镜精索内静脉高位结扎术的对比研究.腹腔镜外科杂志,2013,18(3):219-222.
[17] 赵新辉.单孔与传统三孔法腹腔镜手术治疗双侧精索静脉曲张的对比研究.现代中西结合杂志,2012,21(33):3691-3692.
[18] 陈亮.单孔腹腔镜治疗精索静脉曲张疗效观察.陕西医学杂志,2013,42(8):1023-1024.
[19] 陈志雄,潘翔男,刘永昌.经脐单孔腹腔镜精索静脉高位结扎术术治疗精索静脉曲张.吉林医学,2015,36(14):2984-2985.
[20] Borruto FA, Impellizzeri P, Antonuccio P, et al. Laparoscopic vs open varicocelectomy in children and adolescents: Review of the recent literature and meta-analysis. J Pediatr Surg, 2010,45(12):2464-2469.
[21] Kocvara R, Dvoracek J, Sedlacek J, et al. Lymphatic sparing laparoscopic varicocelectomy: A microsurgical repair. J Urol, 2005,173(5):1751-1754.
[22] Sánchez de Badajoz E, Díaz Ramírez F, Marín Marín J. Endoscopic treatment of varicocele. Arch Esp Urol, 1988,41(1):15-16.
[23] Horeman T, Kurteva DDKDD, Valdastri P, et al. The influence of instrument configuration on tissue handling force in laparoscopy. Surg Innov, 2013,20(3):260-267.
[24] Botden S, Strijkers R, Fransen S, et al. The use of curved vs. Straight instruments in single port access surgery, on standardized box trainer tasks. Surg Endosc, 2011,25(8):2703-2710.
[25] Chen Q, Zhong L, Wu S, et al. Laparoscopic varicocelectomy with single incision in children. Urol J, 2015,12(6):2400-2403.
[26] Lee JY, Ha US, Lee SW. Initial experience of laparoendoscopic single-site radical prostatectomy requiring well-equipped appliances and a skilled technique. Case Rep Oncol, 2010,3 (3):445-450.
[27] Kaouk JH, Autorino R, Kim FJ, et al. Laparoendoscopic single-site surgery in urology: Worldwide multi-institutional analysis of 1076 cases. Eur Urol, 2011,60 (5):998-1005.
[28] Azurin DJ, Go LS, Arroyo LR, et al. Trocar site herniation following laparoscopic cholecystectomy and the significance of an incidental preexisting umbilical hernia. Am Surg, 1995,61(8):718-720.