Staged laparoscopic traction versus laparoscopic staged Fowler- Stephens for intra-abdominal testis: A systematic review and metaanalysis

Document Type : Original Article

Authors

Pediatric Surgery Unit, Department of General Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt.

Abstract

Background: In pediatric urology, undescended testes are frequently seen. The superiority of the Fowler-Stephens
orchiopexy (FSO) or Shehata’s traction orchiopexy (STO) procedures for intra-abdominal testes (IAT) is up for dispute.
The two methods and their results in patients with IATs are compared in this systematic review and meta-analysis.
Patients and Methods: In addition to a manual Google search, we conducted searches in PubMed, Scopus, Web of
Science, Google Scholar, and the Cochrane Library between 2008 and July 2023. All studies that compared the STO and
FSO in the treatment of IATs were included, whether they were case-control, cross-sectional, cohort observational, or
randomized controlled trials. An open Meta Analyst was used for the meta-analysis. The odds ratio (OR) for dichotomous
variables and the mean difference for continuous variables were used to compare the two methods.
Results: The final meta-analysis contained five publications. With a statistically significant P value 0.03), the comparison
revealed that the STO was linked to a greater success rate (87%) than the FSO approach (66%). The OR was reported
to be 2.749 (95% confidence interval: 1.101, 6.864). The STO was observed to cause less atrophy compared with the
FSO technique, as no cases of atrophy were observed in the STO technique, however, FSO was associated with a 12.6%
atrophy rate with a statistically significant P value. The OR was observed to be 0.171 (95% confidence interval: 0.043,
0683, P=0.013).
Conclusion: In IAT children, STO may have a higher success and lower atrophy rates than FSO, despite statistical
significance, however, randomized controlled trials with larger sample sizes and many compared parameters are needed
to confirm these findings.

Keywords

The Egyptian Journal of Surgery
Volume 44, Issue 2
April 2025
Pages 735-744

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