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管状切开补片尿道成形术和移植管状切开补片尿道成形术:系统评价、荟萃分析和序贯试验分析

Tubularized incised plate urethroplasty and grafted tubularized incised plate urethroplasty: systematic review, meta-analysis and trial sequential analysis.

作者信息

Borkar Nitinkumar, Tiwari Charu, Nair Abhijit, Mohanty Debajyoti, Sinha C K, Mahajan Jai Kumar

机构信息

Paediatric Surgery, All India Institute of Medical Sciences-Raipur, Raipur, Chhattisgardh, India.

Department of Anaesthesiology, Ibra Hospital, Ibra, Oman.

出版信息

World J Pediatr Surg. 2024 Feb 21;7(1):e000707. doi: 10.1136/wjps-2023-000707. eCollection 2024.

Abstract

BACKGROUND

Hypospadias is one of the most common genital birth defects. There are around 300 various techniques available for the repair of hypospadias. This study aims to compare the reported outcomes of Tubularized incised plate urethroplasty (TIP) and Grafted TIP (GTIP) repair in children undergoing primary hypospadias repair.

METHODS

This meta-analysisadhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and we framed our research question using the population, intervention, control and outcomes format. We conducted comprehensive electronic searches across various databases, employing a Boolean search strategy with predefined search terms. Only randomized controlled trials (RCTs) were included for quantitative analysis.

RESULTS

Totally, 10 RCTs met our inclusion criteria for quantitative analysis. The results indicated that urethrocutaneous fistula, glans dehiscence, and stricture rates were comparable between the two groups. The incidence of meatal stenosis was found to be significantly lower in the GTIP group with a relative risk (RR) of 0.32 (95% confidence interval (CI) 0.15 to 0.67).

CONCLUSION

The coucomes UCF, glans dehiscence, and stricture rates were comparable between the two groups. Notably, the incidence of meatal stenosis was found to be significantly lower in the grafted TIP group. In terms of operative time, our quantitative synthesis demonstrated that the TIP group had a shorter operative time than the GTIP group with significant heterogeneity.

摘要

背景

尿道下裂是最常见的生殖器先天性缺陷之一。目前有大约300种不同的技术可用于尿道下裂修复。本研究旨在比较管状切开板尿道成形术(TIP)和移植TIP(GTIP)修复术在接受一期尿道下裂修复术儿童中的报告结果。

方法

本荟萃分析遵循系统评价和荟萃分析的首选报告项目指南,我们使用人群、干预、对照和结局格式构建研究问题。我们在各种数据库中进行了全面的电子搜索,采用带有预定义搜索词的布尔搜索策略。仅纳入随机对照试验(RCT)进行定量分析。

结果

共有10项RCT符合我们的定量分析纳入标准。结果表明,两组间尿道皮肤瘘、龟头裂开和狭窄率相当。发现GTIP组尿道口狭窄的发生率显著更低,相对风险(RR)为0.32(95%置信区间(CI)为0.15至0.67)。

结论

两组间尿道皮肤瘘、龟头裂开和狭窄率相当。值得注意的是,移植TIP组尿道口狭窄的发生率显著更低。在手术时间方面,我们的定量综合分析表明,TIP组的手术时间比GTIP组短,且存在显著异质性。

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