Cargando…
A meta-analysis: single or double dartos flap layer in tubularized incised plate urethroplasty to prevent urethrocutaneous fistula?
BACKGROUNDS: Urethrocutaneous fistula is one of the most common complications after urethroplasty. This meta-analysis aims to evaluate the superiority of double dartos flap to single dartos flap in preventing fistula during tubularized incised plate urethroplasty (TIPU), which is one of the most fre...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10286861/ https://www.ncbi.nlm.nih.gov/pubmed/37360362 http://dx.doi.org/10.3389/fped.2023.1091242 |
_version_ | 1785061834740465664 |
---|---|
author | Yuan, Yi Wang, Yu-wen Liang, Yan-nei Wang, Yu-ying Ho, Jun-jie Peng, Tong-yu Zhao, Zhang Deng, Nan |
author_facet | Yuan, Yi Wang, Yu-wen Liang, Yan-nei Wang, Yu-ying Ho, Jun-jie Peng, Tong-yu Zhao, Zhang Deng, Nan |
author_sort | Yuan, Yi |
collection | PubMed |
description | BACKGROUNDS: Urethrocutaneous fistula is one of the most common complications after urethroplasty. This meta-analysis aims to evaluate the superiority of double dartos flap to single dartos flap in preventing fistula during tubularized incised plate urethroplasty (TIPU), which is one of the most frequently used operations for hypospadias. METHODS: We extracted clinical trials under the following included criteria: (1) children with TIPU; (2) a comparison of single and double flap layer; and (3) record of complications with the following excluded criteria: (1) non-comparison and (2) lack of data. Finally, 13 studies from PubMed, Cochrane Library, Scopus, and Embase have been investigated, with a total of 1,185 patients from 2005 to 2022. The quality assessment was conducted according to the Cochrane handbook and the Newcastle–Ottawa scale. A mixed-effect model was utilized to weigh the risk of fistula, phallic rotation, meatal stenosis, and wound dehiscence by the Review Manager V.5.4 software. RESULTS: The double dartos flap layer group excels in descending the risk of postoperative fistula [odds ratio (OR) = 9.56; 95% confidence interval (CI) (4.76, 19.22); P < 0.00001] and phallic rotation [OR = 31.26; 95% CI (9.60, 101.84); P < 0.00001], while there are no differences in the rate of meatal stenosis [OR = 1.49; 95% CI (0.73, 2.70); P = 0.31] and wound dehiscence [OR = 2.30; 95% CI (0.80, 6.63); P = 0.12]. CONCLUSIONS: The routine utility of a double dartos flap layer is recommended as a potential treatment during the tubularized incised plate urethroplasty. SYSTEMATIC REVIEW REGISTRATION: identifier PROSPERO CRD42022366294. |
format | Online Article Text |
id | pubmed-10286861 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-102868612023-06-23 A meta-analysis: single or double dartos flap layer in tubularized incised plate urethroplasty to prevent urethrocutaneous fistula? Yuan, Yi Wang, Yu-wen Liang, Yan-nei Wang, Yu-ying Ho, Jun-jie Peng, Tong-yu Zhao, Zhang Deng, Nan Front Pediatr Pediatrics BACKGROUNDS: Urethrocutaneous fistula is one of the most common complications after urethroplasty. This meta-analysis aims to evaluate the superiority of double dartos flap to single dartos flap in preventing fistula during tubularized incised plate urethroplasty (TIPU), which is one of the most frequently used operations for hypospadias. METHODS: We extracted clinical trials under the following included criteria: (1) children with TIPU; (2) a comparison of single and double flap layer; and (3) record of complications with the following excluded criteria: (1) non-comparison and (2) lack of data. Finally, 13 studies from PubMed, Cochrane Library, Scopus, and Embase have been investigated, with a total of 1,185 patients from 2005 to 2022. The quality assessment was conducted according to the Cochrane handbook and the Newcastle–Ottawa scale. A mixed-effect model was utilized to weigh the risk of fistula, phallic rotation, meatal stenosis, and wound dehiscence by the Review Manager V.5.4 software. RESULTS: The double dartos flap layer group excels in descending the risk of postoperative fistula [odds ratio (OR) = 9.56; 95% confidence interval (CI) (4.76, 19.22); P < 0.00001] and phallic rotation [OR = 31.26; 95% CI (9.60, 101.84); P < 0.00001], while there are no differences in the rate of meatal stenosis [OR = 1.49; 95% CI (0.73, 2.70); P = 0.31] and wound dehiscence [OR = 2.30; 95% CI (0.80, 6.63); P = 0.12]. CONCLUSIONS: The routine utility of a double dartos flap layer is recommended as a potential treatment during the tubularized incised plate urethroplasty. SYSTEMATIC REVIEW REGISTRATION: identifier PROSPERO CRD42022366294. Frontiers Media S.A. 2023-06-08 /pmc/articles/PMC10286861/ /pubmed/37360362 http://dx.doi.org/10.3389/fped.2023.1091242 Text en © 2023 Yuan, Wang, Liang, Wang, Ho, Peng, Zhao, and Deng. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) (https://creativecommons.org/licenses/by/4.0/) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pediatrics Yuan, Yi Wang, Yu-wen Liang, Yan-nei Wang, Yu-ying Ho, Jun-jie Peng, Tong-yu Zhao, Zhang Deng, Nan A meta-analysis: single or double dartos flap layer in tubularized incised plate urethroplasty to prevent urethrocutaneous fistula? |
title | A meta-analysis: single or double dartos flap layer in tubularized incised plate urethroplasty to prevent urethrocutaneous fistula? |
title_full | A meta-analysis: single or double dartos flap layer in tubularized incised plate urethroplasty to prevent urethrocutaneous fistula? |
title_fullStr | A meta-analysis: single or double dartos flap layer in tubularized incised plate urethroplasty to prevent urethrocutaneous fistula? |
title_full_unstemmed | A meta-analysis: single or double dartos flap layer in tubularized incised plate urethroplasty to prevent urethrocutaneous fistula? |
title_short | A meta-analysis: single or double dartos flap layer in tubularized incised plate urethroplasty to prevent urethrocutaneous fistula? |
title_sort | meta-analysis: single or double dartos flap layer in tubularized incised plate urethroplasty to prevent urethrocutaneous fistula? |
topic | Pediatrics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10286861/ https://www.ncbi.nlm.nih.gov/pubmed/37360362 http://dx.doi.org/10.3389/fped.2023.1091242 |
work_keys_str_mv | AT yuanyi ametaanalysissingleordoubledartosflaplayerintubularizedincisedplateurethroplastytopreventurethrocutaneousfistula AT wangyuwen ametaanalysissingleordoubledartosflaplayerintubularizedincisedplateurethroplastytopreventurethrocutaneousfistula AT liangyannei ametaanalysissingleordoubledartosflaplayerintubularizedincisedplateurethroplastytopreventurethrocutaneousfistula AT wangyuying ametaanalysissingleordoubledartosflaplayerintubularizedincisedplateurethroplastytopreventurethrocutaneousfistula AT hojunjie ametaanalysissingleordoubledartosflaplayerintubularizedincisedplateurethroplastytopreventurethrocutaneousfistula AT pengtongyu ametaanalysissingleordoubledartosflaplayerintubularizedincisedplateurethroplastytopreventurethrocutaneousfistula AT zhaozhang ametaanalysissingleordoubledartosflaplayerintubularizedincisedplateurethroplastytopreventurethrocutaneousfistula AT dengnan ametaanalysissingleordoubledartosflaplayerintubularizedincisedplateurethroplastytopreventurethrocutaneousfistula AT yuanyi metaanalysissingleordoubledartosflaplayerintubularizedincisedplateurethroplastytopreventurethrocutaneousfistula AT wangyuwen metaanalysissingleordoubledartosflaplayerintubularizedincisedplateurethroplastytopreventurethrocutaneousfistula AT liangyannei metaanalysissingleordoubledartosflaplayerintubularizedincisedplateurethroplastytopreventurethrocutaneousfistula AT wangyuying metaanalysissingleordoubledartosflaplayerintubularizedincisedplateurethroplastytopreventurethrocutaneousfistula AT hojunjie metaanalysissingleordoubledartosflaplayerintubularizedincisedplateurethroplastytopreventurethrocutaneousfistula AT pengtongyu metaanalysissingleordoubledartosflaplayerintubularizedincisedplateurethroplastytopreventurethrocutaneousfistula AT zhaozhang metaanalysissingleordoubledartosflaplayerintubularizedincisedplateurethroplastytopreventurethrocutaneousfistula AT dengnan metaanalysissingleordoubledartosflaplayerintubularizedincisedplateurethroplastytopreventurethrocutaneousfistula |