Right laparoscopic adrenalectomy vs. left laparoscopic adrenalectomy: a systematic review and meta-analysis

IF 1.6 4区医学 Q2 SURGERY

Videosurgery and Other Miniinvasive Techniques Pub Date : 2021-07-30 DOI:10.5114/wiitm.2021.108212

Yaxuan Wang, Zhan Yang, Xue-liang Chang, Jingdong Li, Yan-ping Zhang, Zhihai Teng, Zhenwei Han

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引用次数: 3

Abstract

Introduction Due to more complex anatomical features, right laparoscopic adrenalectomy (RLA) could be more challenging than left laparoscopic adrenalectomy (LLA). However, this opinion remains elusive. Aim To evaluate the perioperative and postoperative outcomes of RLA versus LLA. Material and methods A systematic literature research of the PubMed, Ovid, Scopus databases (up to March 2021) and citation lists were performed to identify eligible studies. All studies comparing RLA versus LLA were included. Data were analysed using RevMan 5.4 software. Results Overall, 5 studies including 780 patients (RLA 361; LLA 419) were included. The operative time was similar in both groups (WMD –9.38 min, 95% CI: –21.04 to 2.28; p = 0.11). Compared with LLA, RLA showed greater volume of estimated blood loss (EBL) (WMD 13.82 ml, 95% CI: 3.77, 23.88; p = 0.007) and higher conversion rate (OR = 3.45, 95% CI: 1.12 to 10.57; p = 0.03). RLA had comparable complications (OR = 0.88, 95% CI: 0.44 to 1.76; p = 0.71), Clavien Dindo score ≥ 3 complications (OR = 0.38, 95% CI: 0.09 to 1.65; p = 0.20), and length of hospital stay (WMD –0.07 days, 95% CI: –0.35 to 0.21; p = 0.61). The transperitoneal approach analysis showed consistent results. Conclusions RLA is associated with a higher risk of bleeding and higher conversion rate.

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右腹腔镜肾上腺切除术与左腹腔镜肾上腺切除手术的系统回顾和荟萃分析

由于右侧腹腔镜肾上腺切除术(RLA)的解剖特征更为复杂，其手术难度大于左侧腹腔镜肾上腺切除术(LLA)。然而，这种观点仍然难以捉摸。目的比较RLA与LLA的围手术期及术后疗效。材料与方法系统检索PubMed、Ovid、Scopus数据库(截止到2021年3月)和引文列表，筛选符合条件的研究。所有比较RLA和LLA的研究都被纳入。采用RevMan 5.4软件对数据进行分析。结果5项研究共纳入780例患者(RLA 361;包括LLA 419)。两组手术时间相似(WMD -9.38 min, 95% CI: -21.04 ~ 2.28;P = 0.11)。与LLA相比，RLA显示出更大的估计失血量(EBL) (WMD 13.82 ml, 95% CI: 3.77, 23.88;p = 0.007)和更高的转换率(OR = 3.45, 95% CI: 1.12 ~ 10.57;P = 0.03)。RLA并发症相当(OR = 0.88, 95% CI: 0.44 ~ 1.76;p = 0.71)， Clavien Dindo评分≥3个并发症(OR = 0.38, 95% CI: 0.09 ~ 1.65;p = 0.20)和住院时间(WMD -0.07天，95% CI: -0.35至0.21;P = 0.61)。经腹腔入路分析结果一致。结论RLA与较高的出血风险和转换率相关。

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来源期刊

Videosurgery and Other Miniinvasive Techniques 医学-外科

CiteScore

2.80

自引率

23.50%

发文量

审稿时长

12 weeks

期刊介绍： Videosurgery and other miniinvasive techniques serves as a forum for exchange of multidisciplinary experiences in fields such as: surgery, gynaecology, urology, gastroenterology, neurosurgery, ENT surgery, cardiac surgery, anaesthesiology and radiology, as well as other branches of medicine dealing with miniinvasive techniques.