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Comparing the efficacy and safety of laparoscopic and robotic adrenalectomy: a meta-analysis and trial sequential analysis

  • Systematic Review and Meta-analyses
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Abstract

Purpose

A systematic literature review and a meta-analysis were designed and conducted, in order to provide an up-to-date comparison of the robotic (RA) and laparoscopic (LA) adrenalectomy in terms of perioperative efficacy and safety.

Methods

The present meta-analysis was completed in accordance with the guidelines provided by the PRISMA study group and the Cochrane Handbook for Systematic Reviews of Interventions. The electronic scholar databases (Medline, Web of Science, Scopus) were screened. For the reduction of type I errors, a trial sequential analysis (TSA) was performed.

Results

Overall, 21 studies and 2997 patients were included in this study. RA was associated with a significantly lower open conversion rate (OR: 1.79; 95%CI: 1.10, 2.92) and length of hospitalization (LOS WMD: 0.52; 95%CI: 0.2, 0.84). Marginal results regarding blood loss were recorded (WMD: 2.02; 95%CI: 0.0, 4.03). TSA could not validate the superiority of RA in open conversion rate and blood loss. LA and RA were similar in terms of operative duration (P = 0.18) and positive margin (P = 0.81), complications (P = 0.94) and mortality rate (P = 0.45).

Conclusions

Even though RA and LA were equivalent regarding perioperative safety, RA was associated with a favorable LOS.

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Authors and Affiliations

  1. Department of Surgery, University Hospital of Larissa, Mezourlo, 41110, Larissa, Greece

    Konstantinos Perivoliotis, Ioannis Baloyiannis & George Tzovaras

  2. Department of Anesthesiology, University Hospital of Larissa, Mezourlo, 41110, Larissa, Greece

    Chamaidi Sarakatsianou

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  1. Konstantinos Perivoliotis
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  2. Ioannis Baloyiannis
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  3. Chamaidi Sarakatsianou
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  4. George Tzovaras
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Conception and design of the study: Perivoliotis, Baloyiannis. Acquisition of data: Perivoliotis, Sarakatsianou. Drafting the article: Perivoliotis, Baloyiannis. Critical revision: Sarakatsianou, Tzovaras. Final approval: Tzovaras.

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Correspondence to Ioannis Baloyiannis.

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Perivoliotis, K., Baloyiannis, I., Sarakatsianou, C. et al. Comparing the efficacy and safety of laparoscopic and robotic adrenalectomy: a meta-analysis and trial sequential analysis. Langenbecks Arch Surg 405, 125–135 (2020). https://doi.org/10.1007/s00423-020-01860-9

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