4.7 Review

Safety and effectiveness of minimally invasive adrenalectomy versus open adrenalectomy in patients with large adrenal tumors (≥5 cm): A meta-analysis and systematic review

Journal

INTERNATIONAL JOURNAL OF SURGERY
Volume 104, Issue -, Pages -

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1016/j.ijsu.2022.106779

Keywords

Robot-assisted adrenalectomy; Laparoscopic adrenalectomy; Open adrenalectomy; Adrenal tumors

Categories

Funding

  1. Sichuan Province Science and Technology Planning Project [2020YFS0320]
  2. Sichuan Provincial Science and Technology Department Project Support Project [20PJ305]
  3. Nanchong City School Science and Technology Cooperation Project [NSMC20170457]

Ask authors/readers for more resources

This systematic review and meta-analysis compared the safety and effectiveness of minimally invasive adrenalectomy (MIA) with open adrenalectomy (OA) in patients with large adrenal tumors (>= 5 cm). The results showed that MIA was superior to OA in terms of length of stay, drainage time, fasting time, estimated blood loss, and transfusion, while operative time and complications were not statistically different.
Background: This systematic review and meta-analysis compared the safety and effectiveness of minimally invasive adrenalectomy (MIA) with open adrenalectomy (OA) in patients with large adrenal tumors (>= 5 cm). Materials and methods: We performed a systematic review and cumulative meta-analysis of the primary outcomes according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and AMSTAR (Assessing the methodological quality of systematic reviews) Guidelines. Five databases including Medline, PubMed, Cochrane Library, Scopus, and Web of Science were systematically searched. The time frame of the search was set from the creation of the database to March 2022.Results: Ten studies including 898 patients were included. Compared to OA, MIA is superior for length of stay [LOS WMD =-3.52, 95% CI (-4.61,-2.43), P < 0.01], drainage time [DT WMD =-0.68, 95% CI (-1.27,-0.09), P < 0.05] and fasting time [FT WMD =-0.95, 95% CI (-1.35,-0.55), P < 0.01], estimated blood loss [EBL WMD =-314.22, 95% CI (-494.76,-133.69), P < 0.01] and transfusion [WMD =-416.73, 95% CI (-703.75,-129.72), P < 0.01], while operative time (OT) and complications are not statistically different. For pheochromocytoma, MIA remains superior for LOS [WMD =-3.10, 95% CI (-4.61,-1.60), P < 0.01] and EBL [WMD =-273.65, 95% CI (-457.44,-89.86), P < 0.01], while OT and complications are not significantly different.Conclusion: MIA offers advantages over OA in the management of large adrenal tumors, including in the case of a specific large adrenal tumor -large pheochromocytoma.

Authors

I am an author on this paper
Click your name to claim this paper and add it to your profile.

Reviews

Primary Rating

4.7
Not enough ratings

Secondary Ratings

Novelty
-
Significance
-
Scientific rigor
-
Rate this paper

Recommended

No Data Available
No Data Available