Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
J Pediatr Urol. 2023 Jun;19(3):313-319. doi: 10.1016/j.jpurol.2023.02.025. Epub 2023 Mar 10.
The surgical approach for high-level intra-abdominal testis (IAT) is variable. While most pediatric urologists prefer staged Fowler-Stephens orchiopexy (FSO), Shehata publicized a novel approach-known as staged laparoscopic traction orchiopexy (SLTO) or the Shehata technique-to better manage IATs.
This study compares the overall success rates, atrophy rates, retraction rates, and operation times of the two procedures to assist surgeons with developing procedure strategies.
Databases were searched for relevant literature involving these two approaches, and studies meeting the eligibility criteria were involved; RevMan 5.4 was used to conduct this meta-analysis. The relative risk (RR), weighted mean difference, 95% confidence interval (CI), p-value, publication bias, and heterogeneity were calculated.
The Shehata technique demonstrated better performance than staged FSO regarding the overall success and atrophy rate, while the retraction rate and operation time had no statistical difference.
This study revealed that the Shehata technique may be an alternative to staged FSO for managing high-level IATs. Additional high-quality studies regarding the Shehata technique, as well as a long-term follow-up, are required for further and more credible analysis.
高位腹腔内睾丸（IAT）的手术入路存在差异。大多数小儿泌尿科医生倾向于分期 Fowler-Stephens 或阴囊固定术（FSO），而 Shehata 则推广了一种新的方法，即分期腹腔镜牵引阴囊固定术（SLTO）或 Shehata 技术，以更好地处理 IAT。
本研究比较了这两种手术的总体成功率、萎缩率、回缩率和手术时间，以帮助外科医生制定手术策略。
检索数据库中涉及这两种方法的相关文献，并纳入符合入选标准的研究；使用 RevMan 5.4 进行荟萃分析。计算相对风险（RR）、加权均数差、95%置信区间（CI）、p 值、发表偏倚和异质性。
Shehata 技术在总体成功率和萎缩率方面优于分期 FSO，而回缩率和手术时间无统计学差异。
本研究表明，Shehata 技术可能是治疗高位 IAT 的分期 FSO 的替代方法。需要更多高质量的关于 Shehata 技术的研究以及长期随访，以进行进一步更可信的分析。
