Laparoscopic vs open varicocelectomy in children and adolescents: review of the recent literature and meta-analysis.
OBJECTIVE
Laparoscopic varicocelectomy has gained popularity in recent years. The aim of this study was to identify clinical evidence about the reliability of this technique in the recent literature.


METHODS
We performed a Medline search for articles published during the last 10 years, using the key words "varicocele," "treatment," and "adolescent." As limits, we used last 10 years, adolescent, clinical trials, randomized controlled trials, meta-analysis, and multicenter retrospective and prospective studies. The results were investigated in recurrence and hydrocele formation.


RESULTS
We pooled 37 studies, but 26 of these were excluded because they were neither relevant nor concerned an adolescent population. Meta-analysis showed that there was no statistical difference between laparoscopic surgery and open surgery in recurrence rate and postoperative hydrocele rate. In the laparoscopic group, the incidence of recurrence was higher in the patients undergoing artery ligation compared to patients undergoing artery and venous ligation. Furthermore, a lower rate of postoperative hydrocele was recorded in patients undergoing dye injections before laparoscopic ligation.


CONCLUSIONS
Meta-analysis and literature analysis showed that the results after laparoscopic varicocelectomy are comparable to other surgical procedures. The laparoscopic approach has the advantage to treat simultaneously bilateral varicocele.
Department of Medical and Surgical Pediatric Sciences, Unit of Pediatric Surgery, University of Messina, 98125 Messina, Italy. francesca.borruto@virgilio.it
Francesca Astra
FA
Borruto
Pietro
P
Impellizzeri
Pietro
P
Antonuccio
Alessandra
A
Finocchiaro
Gianfranco
G
Scalfari
Francesco
F
Arena
Ciro
C
Esposito
Carmelo
C
Romeo
D000293:Adolescent; D001158:Arteries / Q000601:surgery; D002648:Child; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D004396:Coloring Agents; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy; D008026:Ligation; D008297:Male; D015201:Meta-Analysis as Topic; D015337:Multicenter Studies as Topic / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D012008:Recurrence; D012189:Retrospective Studies; D006848:Testicular Hydrocele / Q000453:epidemiology / Q000209:etiology; D013737:Testis / Q000098:blood supply; D016896:Treatment Outcome; D014646:Varicocele / Q000601:surgery*; D014680:Veins / Q000601:surgery
D004396:Coloring Agents