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Volume 19, Issue 2 (March 2017) 19, 248–255; DOI:10.4103/1008-682X.181194

Comparison of surgical effect and postoperative patient experience between laparoendoscopic single-site and conventional laparoscopic varicocelectomy: a systematic review and meta-analysis

Zheng Zhang, Shu-Juan Zheng, Wen Yu, You-Feng Han, Hai Chen, Yun Chen, Yu-Tian Dai

Department of Andrology, Affiliated Drum Tower Hospital, School of Medicine, Nanjing University, Nanjing 210008, China

Correspondence: Dr. YT Dai (13913957628@163.com)

Date of Submission 10-Aug-2015 Date of Decision 20-Jan-2016 Date of Acceptance 06-Mar-2016 Date of Web Publication 20-May-2016


The present meta-analysis was conducted to compare the clinical effect and patient experience of laparoendoscopic single-site varicocelectomy (LESSV) and conventional laparoscopic varicocelectomy. The candidate studies were included after literature search of database Cochrane Library, PubMed, EMBASE, and MEDLINE. Related information on essential data and outcome measures was extracted from the eligible studies by two independent authors, and a meta-analysis was conducted using STATA 12.0 software. Subgroup analyses were conducted by study design (RCT and non-RCT). The odds ratio (OR) or standardized mean difference (SMD) and their 95% confidence intervals (95% CIs) were used to estimate the outcome measures. Seven articles were included in our meta-analysis. The results indicated that patient who had undergone LESSV had a shorter duration of back to work (overall: SMD = −1.454, 95% CI: −2.502-−0.405, P = 0.007; non-RCT: SMD = −2.906, 95% CI: −3.796-−2.017, P = 0.000; and RCT: SMD = −0.841, 95% CI: −1.393-−0.289, P = 0.003) and less pain experience at 3 h or 6 h (SMD = −0.447, 95% CI: −0.754-−0.139, P = 0.004), day 1 (SMD = −0.477, 95% CI: −0.905-−0.05, P = 0.029), and day 2 (SMD = −0.612, 95% CI: −1.099-−0.125, P = 0.014) postoperatively based on RCT studies. However, the meta-analyses based on operation time, clinical effect (improvement of semen quality and scrotal pain relief), and complications (hydrocele and recurrence) yielded nonsignificant results. In conclusion, LESSV had a rapid recovery and less pain experience over conventional laparoscopic varicocelectomy. However, there was no statistically significant difference between the two varicocelectomy techniques in terms of the clinical effect and the incidence of hydrocele and varicocele recurrence. More high-quality studies are warranted for a comprehensive conclusion.

Keywords: complications; conventional laparoscopic varicocelectomy; laparoendoscopic single-site varicocelectomy; meta-analysis; pain score; semen quality

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