经显微镜和腹腔镜术式对精索静脉曲张疗效及安全性的系统评价和Meta分析  

Systematic Evaluation and Meta-Analysis of Efficacy and Safety of Microscopic and Laparoscopic Surgery for Varicocele

作　　者：李嘉睿 孙翔[2] 罗龙华[2] LI Jia-rui;SUN Xiang;LUO Long-hua(Medical Department of Graduate School,Nanchang University,Nanchang 330006,China;Department of Urology of the First Affiliated Hospital,Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学研究生院医学部,南昌330006 [2]南昌大学第一附属医院泌尿外科,南昌330006

出　　处：《南昌大学学报（医学版）》2020年第4期61-66,共6页Journal of Nanchang University：Medical Sciences

摘　　要：目的系统评价精索静脉曲张手术不同术式(显微镜、腹腔镜)的疗效和安全性。方法从Cochrane图书馆,Embase、PubMed、CNKI数据库搜索2015年1月至2019年3月分别采用显微镜、腹腔镜两种手术方式治疗精索静脉曲张的临床随机对照试验,由两位评价员按照相关限定条件进行筛选,选出符合纳入标准的文献进行Meta分析。结果共有19项研究的2075例患者被纳入。显微镜组手术时间长于腹腔镜组,住院时间短于腹腔镜组(P<0.05);术后6个月显微镜组精子活力高于腹腔镜组,精子密度高于腹腔镜组(P<0.05);显微镜组术后并发症发生率低于腹腔镜组,术后复发率低于腹腔镜组(P<0.05)。结论由于操作的精细要求,使得显微镜辅助精索静脉结扎术手术时间长于腹腔镜术式,但其疗效和安全性均更具优势。Objective To systematically evaluate the efficacy and safety of microscopic and laparoscopic surgery in treatment of varicocele.Methods The Cochrane Library,Embase,PubMed and CNKI were researched for randomized controlled trials(RCTs)related to the treatment of varicocele with microscopic or laparoscopic surgery from January 2015 to March 2019.According to the qualified conditions,the eligible literatures were selected by two evaluators for meta-analysis.Results A total of 19 RCTs(2075 patients)were included in this analysis.Compared with laparoscopic surgery,microscopic surgery prolonged operation time,shortened hospital stay and reduced the incidence of postoperative complications and recurrence(P<0.05).At 6 months after operation,sperm motility and density in microscopic group were higher than those in laparoscopic group(P<0.05).Conclusion Due to the requirements on delicate operation,the operation time of microscope-assisted spermatic vein ligation is longer than that of laparoscopic surgery.However,the efficacy and safety of microscopic surgery are higher than those of laparoscopic surgery for treating varicocele.

关 键 词：精索静脉曲张 腹腔镜手术 显微镜手术 META分析 

分 类 号：R699.8[医药卫生—泌尿科学]