Retroperitoneal laparoscopic adrenalectomy versus transperitoneal laparoscopic adrenalectomy for pheochromocytoma: a systematic review and meta-analysis.
Introduction: To compare the efficacy and safety of retroperitoneal laparoscopic adrenalectomy (RLA) vs. transperi toneal laparoscopic adrenalectomy (TLA) for pheochromocytoma (PHEO). Aim: To perform a systematic review and meta-analysis to evaluate the efficacy and safety of RLA versus TLA for...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Medycyna Praktyczna
2022-10-01
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| Series: | Videosurgery and Other Miniinvasive Techniques |
| Subjects: | |
| Online Access: | https://www.mp.pl/videosurgery/issue/article/16738/ |
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| Summary: | Introduction: To compare the efficacy and safety of retroperitoneal laparoscopic adrenalectomy (RLA) vs. transperi
toneal laparoscopic adrenalectomy (TLA) for pheochromocytoma (PHEO).
Aim: To perform a systematic review and meta-analysis to evaluate the efficacy and safety of RLA versus TLA for
PHEO.
Material and methods: A systematic research of PubMed, Ovid, Scopus (up to June 2022), and citation lists was
performed for all comparative eligible studies of RLA versus TLA for PHEO. Statistical analysis was performed using
RevMan 5.4.
Results: Overall, six studies including 597 patients (RLA 243; TLA 354) were included. RLA was associated with lower
BMI compared to TLA (WMD = –0.81 kg/m2, 95% CI: –1.53 to –0.10; p = 0.03). RLA was associated with smaller
tumor size (WMD = –0.90 cm, 95% CI: –1.59 to –0.20; p = 0.01). RLA was associated with shorter operative time
(WMD = –34.58 min, 95% CI: –40.80 to –28.36; p < 0.001), lower EBL (WMD = –107.91 ml, 95% CI: –145.09, –70.74;
p < 0.001), and a slightly higher HI rate (OR = 1.54, 95% CI: 1.03 to 2.29; p = 0.03). There were no statistically signifi
cant differences for complications (p = 0.71) and Clavien-Dindo score ≥ 3 complications (p = 0.19) for RLA compared to
TLA. RLA was associated with shorter length of hospital stay (WMD = –1.94 days, 95% CI: –2.60 to –1.29; p < 0.001).
Conclusions: For selected PHEO patients, RLA has advantages in terms of operative time, EBL, and length of hospital
stay, but the HI rate is higher. Since the lower BMI and smaller tumor size of RLA reduced the difficulty of surgery,
these results need to be confirmed by further studies. |
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| ISSN: | 1895-4588 2299-0054 |