Adrenal sparing surgery compared with total adrenalectomy for aldosterone producing adenoma:A meta-analysis / 解放军医学杂志

ABSTRACT

Objective To compare the perioperative safety and curative effects oflaparoscopic adrenal sparing surgery (ASS) with laparoscopic total adrenalectomy (TA) for aldosterone producing adenoma (APA).Methods An online systematical retrieval was performed with Pubmed,ScienceDirect,Springerlink,the Cochrane library,CNKI and China Biology Medicine disc for clinical comparative studies published before May 2016,these studies reported the treatment of ASS/partial adrenalectomy (PA) versus TA for APA.The selected studies were applied to Revman 5.3 software for meta-analysis.The main contents were perioperative outcomes (operative time,intra-operative blood loss,and length of hospital stay) and postoperative efficacy (cure rate,partial response rate,inefficiency rate).Results A total of 9 clinical studies (3 English documents and 6 Chinese documents) with 1036 patients were included into the final analysis,among which 544 patients were assigned to ASS group and 492 in TA group.The analyzed results demonstrated no statistical significance between ASS group and TA group on operative time (WMD-2.09min,95％CI-9.86-5.67,P=0.60),length of hospital stay (WMD-0.10d,95％CI-0.32-0.12,P=0.36),intra-operative blood loss (WMD1.13ml,95％CI-8.86-11.12,P=0.82),cure rate (OR=l.07,95％CI0.73-1.58,P=0.72),partial response rate (OR=0.85,95％CI0.57-1.27,P=0.43) and inefficiency rate (OR=2.15,95％CI0.32-14.34,P=0.43).Conclusion For surgical treatment of APA,ASS is technically safe,can achieve reliable postoperative efficacy and a similar therapeutic effect compared with TA,so deserves further application in clinical practice.