Purpose: Laparoscopic and open approaches are considered equivalent surgical options for the management of abdominal undescended testes, the choice of which is dependent upon surgeon experience and preference. We questioned whether immediate post-operative complications were equivalent.
Methods: The American College of Surgeons National Surgical Quality Improvement Program data file was queried for laparoscopic and open orchiopexies of abdominal testes (54650, 54692) from 2012-2014. Data points included: age, ASA class, type of surgeon, length of stay, operative time, complications, immediate reoperation, and readmission. Statistical analyses included Student’s t-test and chi-square.
Results: A total of 1039 laparoscopic and 489 open abdominal orchiopexies were performed. Laparoscopic orchiopexy was performed even more commonly in 2013 (p= 0.018) and 2014 (p<0.001) than in 2012. Patients undergoing the laparoscopic approach were younger (mean 919.8±1123.8 versus 1266.0±1381.5 days, p<0.001). The mean length of stay was shorter for laparoscopic patients (0.17±1.2 versus 0.48±4.4 days, p= 0.035), however open surgeries were quicker (73.7±65.8 versus 85.9±50.5 minutes, p<0.001). While the complication rate was low for both approaches, they were more than twice as likely to occur with the open approach (p= 0.03). There was no statistical difference in reoperation rate (0.3% laparoscopic versus 0.6% open) or readmission rate (1.2% laparoscopic versus 1.8% open).
Conclusions: Although the open approach to abdominal orchiopexy takes less time to perform, the length of stay is longer. Immediate post-operative complications occur rarely, but are more common with the open approach.
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Published on: Apr 15, 2020 Pages: 17-21
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DOI: 10.17352/aur.000010
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