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

PURPOSE: We performed a systematic review and meta-analysis to compare the efficacy and safety between single-incision, transscrotal orchidopexy, and the traditional inguinal orchidopexy in children. METHODS: A systematic search of the electronic databases was conducted to identify studies compared the transscrotal orchidopexy (SO) and inguinal orchidopexy (IO) for children. Parameters, such as operative time, the incidence of patent processus vaginalis, and postoperative complications, including wound infection, testicular atrophy, testicular reascent, hernia, or hydrocele, were pooled and compared by meta-analysis. RESULTS: Among the 1376 children with palpable undescended testes (UDTs) included in the eight studies, 697 had received SO and 679 IO. There were shorter operative times with the SO approach compared with IO. However, no significant difference was found between SO and IO in the incidence of patent processus vaginalis and postoperative complications, including wound infection, testicular atrophy, testicular reascent, and hernia. CONCLUSION: SO is a safe and effective surgical approach alternative to IO for pediatric UDTs. Compared with IO, SO has the advantage of shorter operative times. Besides, the incidence of postoperative wound infection may be slightly lower in SO. We suggest that SO should be considered as an acceptable option for children with UDTs.

Laparoscopic versus open splenectomy in children: a systematic review and meta-analysis.

PURPOSE: We conducted a systematic review and meta-analysis to compare the clinical outcomes between laparoscopic splenectomy and the traditional open splenectomy in children. METHODS: Literature searches were conducted to identify studies having compared the laparoscopic splenectomy (LS) and open splenectomy (OS) for children. Parameters such as operative time, blood loss, length of postoperative stay, the removal of accessory spleens and postoperative complications including postoperative high fever, acute chest syndrome (ACS), and ileus were pooled and compared by meta-analysis. RESULTS: Among the 922 pediatric participants included in the 10 studies, 508 had received LS and 414 OS. There were shorter length of hospital stays, less blood loss, and longer operative times with the LS approach compared with OS. However, no significant difference was found between LS and OS in the secondary outcome, such as the removal of accessory spleens or postoperative complications including postoperative high fever, ACS, and ileus. CONCLUSION: LS is a feasible, safe, and effective surgical procedure alternative to OS for pediatric patients. Compared with OS, LS has the advantage of shorter hospital stay and less blood loss. Besides, total postoperative complications may be slightly lower in LS. We conclude that LS should be considered an acceptable option for children.