title: Laparoscopic versus open orchiopexy for non-palpable undescended testes in children: a systemic review and meta-analysis.
abstract: BACKGROUND
  Laparoscopic orchidopexy (LO) has been widespread used in the management of non-palpable testis (NPT) in children. However, the real advantages of LO over traditional open orchidopexy (OO) still remain exclusive.
  
  
  METHODS
  Published studies until August 31, 2010 were searched from Medline, Embase, Ovid, Web of Science, and Cochrane databases. Randomized controlled trials (RCTs) and observational clinical studies (OCSs) with a comparison of LO and OO were included for a systemic review and meta-analysis.
  
  
  RESULTS
  Out of 226 studies, 2 RCTs and 5 OCSs were eligible for inclusion criteria, comprising 176 cases of LO and 263 cases of OO. The hospital stay of LO was significantly shorter than that of OO (WMD = -0.66; 95% confidence interval [CI] = -0.95 to -0.37; P < 0.00001). However, no significant difference was observed between LO and OO in operative time (WMD = 4.02; 95% CI = -9.89 to 17.93; P = 0.57), time to resume feeding (WMD = -2.29; 95% CI = -6.78 to 2.20; P = 0.32) or full activity (WMD = -9.71; 95% CI = -27.84 to 8.42; P = 0.29), recurrence (OR = 0.60; 95% CI = 0.13 to 2.72; P = 0.51), viable testis rate (OR = 1.61; 95% CI = 0.30 to 8.52; P = 0.58), success rate (OR = 1.41; 95% CI = 0.44 to 4.46; P = 0.56), and testicular atrophy (OR = 1.70; 95% CI = 0.49 to 5.98; P = 0.40).
  
  
  CONCLUSIONS
  Although shorter hospital stay is noted in LO, it does not provide significant advantage over open surgery for treating NPT. However, due to the publishing bias, a series of RCTs are necessary to explore the efficiencies of LO in the management of NPT in children.
authors.affiliation: Department of Urology, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.
authors.forename: Ju
authors.initials: J
authors.lastname: Guo
authors.forename: Zhulin
authors.initials: Z
authors.lastname: Liang
authors.forename: Huanyu
authors.initials: H
authors.lastname: Zhang
authors.forename: Chunlei
authors.initials: C
authors.lastname: Yang
authors.forename: Jiarui
authors.initials: J
authors.lastname: Pu
authors.forename: Hong
authors.initials: H
authors.lastname: Mei
authors.forename: Liduan
authors.initials: L
authors.lastname: Zheng
authors.forename: Fuqing
authors.initials: F
authors.lastname: Zeng
authors.forename: Qiangsong
authors.initials: Q
authors.lastname: Tong
mesh_terms: D003456:Cryptorchidism / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D056126:Orchiopexy