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Part Two: Meta-AnalysisLymphatic Sparing Versus Lymphatic Non-Sparing Laparoscopic Varicocelectomy in Children and Adolescents: A Systematic Review and Meta-AnalysisObjective: The aim of this study was to explore the true efficacy and potential advantagesof lymphatic sparing laparoscopic varicocelectomy (LSV) over lymphatic non-sparing laparoscopic varicocelectomy (LNSV) in children and adolescents.Methods: A search was made for studies published up until 31 August 2010 using the terms “lymphatic sparing varicocelectomy”, “laparoscopy”, “adolescent” and “children” in the Medline, Embase, Ovid, Web of Science, and Cochrane databases. Randomized controlled trials (RCTs) and observational clinical studies (OCSs) comparing LSV and LNSV were included. A systematic review and meta-analysis was erformed using odds ratios (ORs) for dichotomous variables.Results: Out of 127 studies, 2 RCTs and 4 OCSs were eligible for inclusion, comprising 489 cases of LSV and 307 cases of LNSV. The hydrocele rates after LSV were signifi cantly lower than after LNSV (OR = 0.19; 95 % confi dence interval [CI] = 0.10 to 0.36; p 0.00001). However, no significant difference was observed between LSV and LNSV with regard to recurrence (OR = 0.65; 95 % CI = 0.32 – 1.33; p = 0.24) or catch-up growth (OR= 2.14; 95 % CI = 0.97 – 4.72; p = 0.06).Conclusion: LSV is valuable in reducing the incidence of postoperative hydrocele, with similar recurrence and catch-up growth rates as LNSV. A series of RCTs are warranted to explore the efficacy of LSV in the management of varicocele in children and adolescents.Key words: lymphatic sparing varicocelectomy; laparoscopy; adolescent; children;meta-analysis独创性声明本人郑重声明，本学位论文是本人在导师指导下进行的研究工作及取得的研究成 果的总结。尽我所知，除文中已经标明引用的内容外，本论文不包含任何其他个人或 集体已经发表或撰写过的研究成果。对本文的研究做出贡献的个人和集体，均已在文 中以明确方式标明。本人完全意识到本人将承担本声明引起的一切法律后果。学位论文作者签名：日期：年月日学位论文版权使用授权书本学位论文作者完全了解学校有关保留、使用学位论文的规定，即：学校有权保 留并向国家有关部门或机构送交论文的复印件和电子版，允许论文被查阅和借阅。本 人授权华中科技大学可以将本学位论文的全部或部分内容编入有关数据库进行检索， 可以采用影印、缩印或扫描等复制手段保存和汇编本学