Retroperitoneal versus transperitoneal laparoscopic adrenalectomy: a systematic literature review and meta-analysis..

Abstract

Introduction: The most common option for surgical management of the majority of adrenal illnesses is laparoscopic adrenalectomy. TLA substituted open adrenalectomy through laparotomy and is currently the favored operating treatment for the management of small benign adrenal cancers. Retroperitoneal laparoscopic adrenalectomy (RLA) has additionally been defined as an alternative laparoscopic approach. Aim: This research aimed to compare retroperitoneal and transperitoneal laparoscopic adrenalectomy within a non-randomised comparative (NRT) trials and updated meta-analysis of randomized controlled (RCT).Methods: A total of 11 studies have been chosen for the present analysis, involving a total of 3454 cases undergoing a total of 3474 laparoscopic adrenalectomies. A total of 2128 patients underwent TLA, whereas 1329 cases underwent retroperitoneal laparoscopic adrenalectomy (RLA). Results: Regarding studies reported on the difference in operating time and bleeding with cases within TLA group and RLA group; significant heterogeneity was determined. Consequently, a random effect model was applied for analysis. The combined MD and 95% confidence intervals results demonstrated statistically insignificant variance among groups.AS according to studies reported on the difference in time to ambulation, intraoperative complications, postoperative complications and mortality rate with cases within TLA group and RLA group; insignificant heterogeneity identified. Consequently, a fixed effect model has been used for analysis. The combined MD and 95% confidence intervals results demonstrated statistically insignificant variance among groups.Conclusion: The two standard minimal access adrenalectomy techniques (TLA and RLA) may be securely performed on cases who are chosen properly. TLA is favored for large tumors, bilateral tumors, less frequent intraoperative blood pressure peaks and for the learning process. RLA may be favored for cardiac and previous abdominal surgery patients.