eISSN: 2299-0054
ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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3/2022
vol. 17
 
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abstract:
Review in Surgery

Peri- and postoperative outcomes of laparoscopic adrenalectomy in nonobese versus obese patients: a systematic review and meta-analysis

Zhongyou Xia
1, 2
,
Haolin Liu
3
,
Peng Gu
4
,
Zonghai He
4
,
Jinze Li
3
,
Fei Yang
5
,
Hongtao Tu
2
,
Ji Wu
1
,
Xiaodong Liu
4

  1. Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, Sichuan, China
  2. Kunming Medical University, Kunming, Yunnan, China
  3. Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
  4. Department of Urology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
  5. Department of Neurology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, China
Videosurgery Miniinv 2022; 17 (3): 430–440
DOI: https://doi.org/10.5114/wiitm.2022.116407
Online publish date: 2022/05/19
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Introduction
Obesity is generally thought to increase the difficulty and complications of surgery. Laparoscopic adrenalectomy has become the standard operation for adrenal tumors at present.

Aim
To assess whether laparoscopic adrenalectomy (LA) can be used for obese patients with adrenal tumor.

Material and methods
We systematically searched PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), and Science databases and Cochrane Library, and the search time is up to January 2022. We used STATA 16.0 and RevMan 5.4 software for data processing and statistical analysis.

Results
Eight studies were included in the meta-analysis. The meta-analysis results showed that compared with the nonobese group, the obese group had a significantly longer operation time (OT) (weighted mean difference (WMD): –10.02, 95% confidence interval (CI): –19.16 to 0.87, p = 0.03). It also had higher estimated blood loss (WMD: –13.15, 95% CI: –35.92 to 9.63, p = 0.26) and conversion rate (odds ratio (OR): 0.70, 95% CI: 1.31 to 1.60, p = 0.40), longer length of hospital stay (LOS) (WMD: –0.04, 95% CI: –0.47 to 0.39, p = 0.86), and a higher number of complications (odds ratio (OR) = 0.71, 95% CI: 0.49 to 1.02, p = 0.06), but these differences were not statistically significant. Additionally, in subgroup analysis longer OT (p = 0.0001) and LOS (p = 0.007) were associated with retroperitoneal laparoscopic adrenalectomy for obesity.

Conclusions
Our meta-analysis suggests that LA is feasible and effective in patients with obesity.

keywords:

obesity, adrenalectomy, meta-analysis, body mass index, laparoscopic
  
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