Laparoscopic versus robotic adrenalectomy: A comprehensive meta-analysis.
Journal Article (Review;Journal Article)
Background
The benefit of robotic adrenalectomy (RA) compared to laparoscopic adrenalectomy (LA) is still debatable. The purpose of this paper was to systematically review and synthesize all available evidence comparing RA to LA so as to evaluate which procedure provides superior clinical outcomes.Methods
A systematic literature search of PubMed and Scopus databases was performed with respect to the PRISMA statement (end-of-search date: January 31, 2016). Data on perioperative variables were extracted by three independent reviewers. Data were pooled using a random-effects model.Results
Twenty-seven studies were included in this review (13 comparative and 14 non-comparative). Overall, 1162 patients underwent adrenalectomy (747 treated with RA and 415 with LA). There was no significant difference between the robotic and the laparoscopic groups for intraoperative complications (OR: 1.20; 95%CI, 0.33-4.38), postoperative complications (OR: 0.69; 95% CI, 0.36-1.31), mortality (OR: 0.42; 95%CI, 0.07-2.72), conversion to laparotomy (OR: 0.51; 95%CI, 0.21-1.23), conversion to laparotomy or laparoscopy (OR: 0.73; 95%CI, 0.32-1.69) and blood loss (WMD: -9.78; 95%, -22.10 to 2.53). For patients treated with RA, there was a significantly shorter hospital stay (WMD: -0.40; 95% CI, -0.64 to -0.17) and a significantly longer operating time (WMD: 15.60; 95%CI, 2.12 to 29.08).Conclusions
Robotic adrenalectomy is a safe and feasible procedure with similar clinical outcomes as the laparoscopic approach in selected patient populations. High quality RCTs as well as uniform and detailed reporting of outcomes are needed to determine the role and cost-effectiveness of robotic adrenal surgery in the years to come.Full Text
Duke Authors
Cited Authors
- Economopoulos, KP; Mylonas, KS; Stamou, AA; Theocharidis, V; Sergentanis, TN; Psaltopoulou, T; Richards, ML
Published Date
- February 2017
Published In
Volume / Issue
- 38 /
Start / End Page
- 95 - 104
PubMed ID
- 28043926
Electronic International Standard Serial Number (EISSN)
- 1743-9159
International Standard Serial Number (ISSN)
- 1743-9191
Digital Object Identifier (DOI)
- 10.1016/j.ijsu.2016.12.118
Language
- eng