Yang Zhenzhen,Li Jiayi,Liu Pei,et al.Efficacy of one-stage Duckett versus staged Bracka urethroplasty for nondistal hypospadias: a meta-analysis[J].Journal of Clinical Pediatric Surgery,,22():168-179.[doi:10.3760/cma.j.cn101785-202202018-014]
Efficacy of one-stage Duckett versus staged Bracka urethroplasty for nondistal hypospadias: a meta-analysis
- Abstract:
- Objective To review the currently available data and evaluate the efficacy of one-stage Duckett versus staged Bracka urethroplasty for non-distal hypospadias through Meta-analysis.Methods The database of PubMed,Embase,Web of Science,Cochrane Library,CNKI,Wanfang and VIP were searched for randomized or non-randomized controlled trials,cohort studies and case-control studies of one-stage Duckett versus staged Bracka urethroplasty for non-distal hypospadias.The measurement parameters included overall postoperative complications and individual complications(urethral fistula,urethral stricture,urethral diverticulum,wound dehiscence & graft-related complications).Meta-analysis was performed with RevMan 5.4 software.Results A total of 3 713 children were collected from 41 articles examining the effectiveness of one-stage Duckett urethroplasty(n=2 395)versus staged Bracka urethroplasty(n=1 318)were included for Meta-analysis.Meta-analysis results indicated that marked inter-group differences existed in occurrence rate of postoperative urethral fistula(RD=0.17 and RD=0.10,P<0.05),occurrence rate of urethral stricture(RD=0.10 and RD=0.03,P<0.05),occurrence rate of diverticula(RD=0.04 and RD=0.02,P<0.05)and occurrence rate of postoperative wound dehiscence(RD=0.02 and RD=0.04,P<0.05).Meta-analysis results of 5 comparative studies showed that total complication rate after one-stage Duckett urethroplasty was higher than that of staged Brack(OR=2.63,95%CI:1.54-4.50,P<0.05).Operative frequency of one-stage Duckett urethroplasty and staged bracka urethroplasty were 1.29 and 2.15 respectively.Conclusion The occurrence rate of total complications,urethral fistula,urethral stricture and urethral diverticulum after one-stage Duckett urethroplasty was higher than that of staged Bracka.Graft-related complication rate after staged Bracka urethroplasty is 5%.One-stage Duckett urethroplasty for non-distal hypospadias requires fewer operations.
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Memo
收稿日期:2022-5-5。
通讯作者:张潍平,Email:zhangwpp@163.com