Short-term outcomes in obese and non-obese patients undergoing transperitoneal laparoscopic adrenalectomy for benign or malignant adrenal diseases: an updated systematic review and meta-analysis.

IF 2.1 4区医学 Q3 ONCOLOGY

Chinese clinical oncology Pub Date : 2024-10-01 DOI:10.21037/cco-24-55

Maurizio Zizzo, Andrea Morini, Magda Zanelli, Chiara Grasselli, Francesca Sanguedolce, Andrea Palicelli, Giuseppe Broggi, Nektarios I Koufopoulos, Lucia Mangone, Melissa Nardecchia, Angelo Cormio, Rosario Caltabiano, Giulia Besutti, Stefano Ascani, Massimiliano Fabozzi

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引用次数: 0

Abstract

Background: Transperitoneal laparoscopic adrenalectomy (TLA) is the most frequently chosen approach in adrenal surgery. At present, impact of obesity on patient outcomes following adrenal surgery is frequently under discussion. We intended to offer updated evidence thanks to a comparison between intraoperative and perioperative outcomes in non-obese and obese patients, who underwent TLA for benign or malignant adrenal diseases.

Methods: Our systematic review made use of Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines. Articles of interest turned out from a search with PubMed/MEDLINE, Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials-CENTRAL), Web of Science (Science and Social Science Citation Index), and Scopus databases. We evaluated two groups of outcomes: intraoperative (operative time, intraoperative complications rate, estimated blood loss (EBL), transfusion rate, conversion to open surgery rate) and postoperative (overall postoperative complications rate, major postoperative complications rate, length of hospital stay). RevMan (Computer program) Version 5.4 was used to perform the meta-analysis. The heterogeneity of the included studies in the meta-analysis was assessed by using the I2 statist.

Results: The 8 included comparative studies (1,646 patients: 995 non-obese versus 651 obese) had a time frame of approximately 30 years (1994-2020) and an observational nature. Meta-analysis showed no differences in terms of operative time, intraoperative complications rate, EBL, transfusion rate, conversion to open surgery rate, overall postoperative complications rate, major (Clavien-Dindo ≥ III) postoperative complications rate, length of hospital stay between non-obese and obese populations.

Conclusions: We can say that obesity does not impact TLA safety and effectiveness. Due to biases among meta-analyzed studies (small overall sample size and small number of events analyzed, in particular), careful interpretation is needed to interpret our results. Additional randomized, possibly multi-center trials may contribute to confirm our results.

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接受经腹腔镜肾上腺切除术治疗良性或恶性肾上腺疾病的肥胖和非肥胖患者的短期疗效：最新系统综述和荟萃分析。

背景：经腹腔镜肾上腺切除术（TLA）是肾上腺手术中最常用的方法。目前，肥胖对肾上腺手术后患者预后的影响经常被讨论。我们希望通过比较因良性或恶性肾上腺疾病而接受 TLA 手术的非肥胖患者和肥胖患者的术中和围手术期结果来提供最新证据：我们的系统综述采用了系统综述和元分析首选报告项目（PRISMA）指南。我们在 PubMed/MEDLINE、Cochrane 图书馆（Cochrane 系统综述数据库、Cochrane 对照试验中央注册中心-CENTRAL）、Web of Science（科学与社会科学引文索引）和 Scopus 数据库中检索了感兴趣的文章。我们评估了两组结果：术中（手术时间、术中并发症发生率、估计失血量（EBL）、输血率、转为开放手术率）和术后（术后总体并发症发生率、术后主要并发症发生率、住院时间）。RevMan（计算机程序）5.4版用于进行荟萃分析。荟萃分析中纳入研究的异质性采用 I2 统计量进行评估：所纳入的 8 项比较研究（1 646 名患者：995 名非肥胖患者与 651 名肥胖患者）的时间跨度约为 30 年（1994-2020 年），且均为观察性研究。Meta分析表明，非肥胖和肥胖人群在手术时间、术中并发症发生率、EBL、输血率、转为开放手术率、术后总并发症发生率、主要（Clavien-Dindo≥III）术后并发症发生率、住院时间等方面均无差异：我们可以说，肥胖不会影响 TLA 的安全性和有效性。由于荟萃分析研究之间存在偏差（特别是总体样本量小和分析的事件数量少），因此需要对我们的结果进行仔细解读。更多的随机试验（可能是多中心试验）可能有助于证实我们的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Chinese clinical oncology ONCOLOGY-

CiteScore

3.90

自引率

0.00%

发文量

期刊介绍： The Chinese Clinical Oncology (Print ISSN 2304-3865; Online ISSN 2304-3873; Chin Clin Oncol; CCO) publishes articles that describe new findings in the field of oncology, and provides current and practical information on diagnosis, prevention and clinical investigations of cancer. Specific areas of interest include, but are not limited to: multimodality therapy, biomarkers, imaging, tumor biology, pathology, chemoprevention, and technical advances related to cancer. The aim of the Journal is to provide a forum for the dissemination of original research articles as well as review articles in all areas related to cancer. It is an international, peer-reviewed journal with a focus on cutting-edge findings in this rapidly changing field. To that end, Chin Clin Oncol is dedicated to translating the latest research developments into best multimodality practice. The journal features a distinguished editorial board, which brings together a team of highly experienced specialists in cancer treatment and research. The diverse experience of the board members allows our editorial panel to lend their expertise to a broad spectrum of cancer subjects.