title: Lymphatic sparing versus lymphatic non-sparing laparoscopic varicocelectomy in children and adolescents: a systematic review and meta-analysis.
abstract: OBJECTIVE
  The aim of this study was to explore the true efficacy and potential advantages of lymphatic sparing laparoscopic varicocelectomy (LSV) over lymphatic non-sparing laparoscopic varicocelectomy (LNSV) in children and adolescents.
  
  
  METHODS
  A search was made for studies published up until 31 August 2010 using the terms "lymphatic sparing varicocelectomy", "laparoscopy", "adolescent" and "children" in the Medline, Embase, Ovid, Web of Science, and Cochrane databases. Randomized controlled trials (RCTs) and observational clinical studies (OCSs) comparing LSV and LNSV were included. A systematic review and meta-analysis was performed using odds ratios (ORs) for dichotomous variables.
  
  
  RESULTS
  Out of 127 studies, 2 RCTs and 4 OCSs were eligible for inclusion, comprising 489 cases of LSV and 307 cases of LNSV. The hydrocele rates after LSV were significantly lower than after LNSV (OR = 0.19; 95% confidence interval [CI] = 0.10 to 0.36; p < 0.00001). However, no significant difference was observed between LSV and LNSV with regard to recurrence (OR = 0.65; 95% CI = 0.32-1.33; p = 0.24) or catch-up growth (OR = 2.14; 95% CI =0.97-4.72; p = 0.06).
  
  
  CONCLUSIONS
  LSV is valuable in reducing the incidence of postoperative hydrocele, with similar recurrence and catch-up growth rates as LNSV. A series of RCTs are warranted to explore the efficacy of LSV in the management of varicocele in children and adolescents.
authors.affiliation: Union Hospital of Tongji Medical College, Department of Urology, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Liang
authors.forename: J
authors.initials: J
authors.lastname: Guo
authors.forename: H
authors.initials: H
authors.lastname: Zhang
authors.forename: C
authors.initials: C
authors.lastname: Yang
authors.forename: J
authors.initials: J
authors.lastname: Pu
authors.forename: H
authors.initials: H
authors.lastname: Mei
authors.forename: L
authors.initials: L
authors.lastname: Zheng
authors.forename: Q
authors.initials: Q
authors.lastname: Tong
mesh_terms: D000293:Adolescent; D002648:Child; D006801:Humans; D010535:Laparoscopy; D042601:Lymphatic Vessels / Q000601:surgery*; D008297:Male; D014646:Varicocele / Q000601:surgery*; D055815:Young Adult