Affiliation:
1. Department of Urology, The Affiliated Nanchong Central Hospital of North Sichuan Medical College (University)
2. Department of Urology, The Second Hospital of Lanzhou University Medical School, Lanzhou, Gansu Province, China
3. Department of Urology, Affiliated Hospital of Southwest Medical University
4. Department of Urology, Nanchong Central Hospital, Nanchong, Sichuan Province
Abstract
Background:
The effectiveness and safety of laparoscopic adrenalectomy (LA) under different routes for the treatment of large pheochromocytomas (PCCs) is unknown.
Materials and methods:
This meta-analysis and systematic review was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and AMSTAR (Assessing the methodological quality of systematic reviews) Guidelines. Three databases were systematically searched, including Medline, PubMed, and Web of Science. The time frame of the search was set from the creation of the database to October 2022. Perioperative outcomes were divided into two groups according to tumor size: SMALL group (≤6 cm in diameter), LARGE group (>6 cm in diameter).
Results:
Eight studies including 600 patients were included. In the LA group, complications was comparable in both groups (SMALL group and LARGE group), and the LARGE group had longer operative time [OT weighted mean difference (WMD)=32.55; 95% CI: 11.17, 53.92; P<0.01], length of stay (LOS WMD=0.82; 95% CI: 0.19, 1.44; P<0.05), more estimated blood loss (EBL WMD=85.26; 95% CI: 20.71, 149.82; P<0.05), hypertension [odds ratio (OR)=3.99; 95% CI: 1.84, 8.65; P<0.01], hypotension (OR=1.84; 95% CI: 1.11, 3.05; P<0.05), and conversion (OR=5.60; 95% CI: 1.56, 20.13; P<0.01). In the transabdominal LA group, OT, LOS, EBL, complications, hypertension, and hypotension were the same in both groups. In the retroperitoneal LA group, complications and hypotension were the same in both groups, while the LARGE group had longer OT (WMD=52.07; 95% CI: 26.95, 77.20; P<0.01), LOS (WMD=0.51; 95% CI: 0.00, 1.01; P<0.05), more EBL (WMD=92.99; 95% CI: 27.70, 158.28; P<0.01) and higher rates of hypertension (OR=6.03; 95% CI: 1.95, 18.61; P<0.01).
Conclusions:
LA remains a safe and effective approach for large PCC. Transabdominal LA is superior to retroperitoneal LA.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Cited by
1 articles.
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