Shike Wu1, Hao Lai1, Jiangyang Zhao2, Jiansi Chen1, Xianwei Mo1, Hongqun Zuo1, Yuan Lin1. 1. Department of Gastrointestinal Surgery, Affiliated Tumor Hospital of Guangxi Medical University Nanning 530021, Guangxi Autonomous Region, China. 2. Department of Clinical Laboratory, Children's Hospital, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning 530003, Guangxi , China.
Abstract
PURPOSE: Previous meta-analyses that compared the outcome of laparoendoscopic single-site adrenalectomy (LESSA) and conventional laparoscopic adrenalectomy (CLA) have not shown consistent results. The aim of this meta-analysis was to reassess current evidence regarding the efficacy and safety of LESSA versus CLA. MATERIALS AND METHODS: A literature search of PubMed, Embase, Medline, and the Cochrane Library was performed to identify eligible articles up until September 2015. Quantitative variables were calculated using the weighted mean differences (WMDs), and qualitative variables were pooled using odds ratios (ORs). RESULTS: Ten retrospective studies, including a total of 704 cases, were identified. Patients in the LESSA group benefitted from shorter length of hospital stay (95% confidence interval [CI]: -1.27 to -0.36, WMD: -0.81, P < .001) and better postoperative pain scores (95% CI: -1.51 to -0.99, WMD: 1.25, P < .001). There was no significant difference between the two techniques in operative time, estimated blood loss, resumption of oral intake, dose of analgesic required, perioperative complications, conversion, transfusion, or pain medications required. CONCLUSIONS: Based on current evidence, LESSA appear to be a safe and feasible alternative to CLA with a shorter length of hospital stay and lower postoperative pain scores in certain patients. We await high-quality, double-blind randomized clinical trials with long-term follow-up to confirm and update the findings of this analysis; future studies should focus on failure of technique, cosmesis, and cost.
PURPOSE: Previous meta-analyses that compared the outcome of laparoendoscopic single-site adrenalectomy (LESSA) and conventional laparoscopic adrenalectomy (CLA) have not shown consistent results. The aim of this meta-analysis was to reassess current evidence regarding the efficacy and safety of LESSA versus CLA. MATERIALS AND METHODS: A literature search of PubMed, Embase, Medline, and the Cochrane Library was performed to identify eligible articles up until September 2015. Quantitative variables were calculated using the weighted mean differences (WMDs), and qualitative variables were pooled using odds ratios (ORs). RESULTS: Ten retrospective studies, including a total of 704 cases, were identified. Patients in the LESSA group benefitted from shorter length of hospital stay (95% confidence interval [CI]: -1.27 to -0.36, WMD: -0.81, P < .001) and better postoperative pain scores (95% CI: -1.51 to -0.99, WMD: 1.25, P < .001). There was no significant difference between the two techniques in operative time, estimated blood loss, resumption of oral intake, dose of analgesic required, perioperative complications, conversion, transfusion, or pain medications required. CONCLUSIONS: Based on current evidence, LESSA appear to be a safe and feasible alternative to CLA with a shorter length of hospital stay and lower postoperative pain scores in certain patients. We await high-quality, double-blind randomized clinical trials with long-term follow-up to confirm and update the findings of this analysis; future studies should focus on failure of technique, cosmesis, and cost.
Authors: Esmee V van Helden; Allon van Uitert; Michiel C Warlé; Johan F Langenhuijsen; Kim I Albers; Monique A H Steegers; Henri J L M Timmers; Frank C H d'Ancona; Selina E I van der Wal; Gert Jan Scheffer; Christiaan Keijzer Journal: BMC Anesthesiol Date: 2022-05-19 Impact factor: 2.376
Authors: Salvador Morales-Conde; Andrea Peeters; Yannick M Meyer; Stavros A Antoniou; Isaías Alarcón Del Agua; Alberto Arezzo; Simone Arolfo; Amir Ben Yehuda; Luigi Boni; Elisa Cassinotti; Giovanni Dapri; Tao Yang; Sofie Fransen; Antonello Forgione; Shahab Hajibandeh; Shahin Hajibandeh; Michele Mazzola; Marco Migliore; Christof Mittermair; Doris Mittermair; Antonio Morandeira-Rivas; Carlos Moreno-Sanz; Andrea Morlacchi; Eran Nizri; Myrthe Nuijts; Jonas Raakow; Francisco M Sánchez-Margallo; Juan A Sánchez-Margallo; Amir Szold; Helmut Weiss; Michael Weiss; Ricardo Zorron; Nicole D Bouvy Journal: Surg Endosc Date: 2019-02-15 Impact factor: 4.584