BACKGROUND To compare the perioperative outcomes and safety of transperitoneal laparoscopic adrenalectomy with those of retroperitoneal laparoscopic adrenalectomy for patients with pheochromocytoma. METHODS We searched PubMed, EMBASE and the Cochrane Central Register for studies from 1999 to 2019 to assess the perioperative outcomes and safety of transperitoneal laparoscopic adrenalectomy and the retroperitoneal approach for laparoscopic adrenalectomy in patients with pheochromocytoma. After data extraction and quality assessments, we used RevMan 5.2 to pool the data. RESULTS Four retrospective studies were obtained in our meta-analysis. Patients who underwent retroperitoneal laparoscopic adrenalectomy were associated with shorter operative time (WMD: 34.91, 95% CI: 27.02 to 42.80, I2 = 15%; p < 0.01), less intraoperative blood loss (WMD: 139.32, 95% CI: 125.38 to 153.26, I2 = 0, p < 0.01), and a shorter hospital stay (WMD: 2, 95% CI: 1.18 to 2.82, I2 = 82%, p < 0.01) than patients who underwent transperitoneal laparoscopic adrenalectomy. No significant differences were found in the complication rate (OR: 1.58, 95% CI: 0.58 to 4.33, I2 = 0; p = 0.38) or in the incidence of hemodynamic crisis (OR: 0.74, 95% CI: 0.19 to 2.94, p = 0.67) between the two groups. CONCLUSION Retroperitoneal laparoscopic adrenalectomy could achieve better perioperative outcomes than the transperitoneal approach for patients with pheochromocytoma.

中文翻译：

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腹膜后与腹膜镜肾上腺切除术围手术期结局及嗜铬细胞瘤安全性的比较：一项荟萃分析。

背景为了比较腹膜后腹腔镜肾上腺切除术与腹膜后腹腔镜肾上腺切除术对嗜铬细胞瘤患者的围手术期结果和安全性。方法我们检索了PubMed，EMBASE和Cochrane Central Register进行的1999年至2019年的研究，以评估嗜铬细胞瘤患者经腹腔镜下肾上腺切除术的围手术期结局，安全性以及腹膜后肾上腺切除术的腹膜后方法。在数据提取和质量评估之后，我们使用RevMan 5.2合并数据。结果在我们的荟萃分析中获得了四项回顾性研究。腹膜后腹腔镜肾上腺切除术的患者手术时间较短（WMD：34.91，95％CI：27.02至42.80，I2 = 15％; p <0.01），术中失血较少（WMD：139。32，95％CI：125.38至153.26，I2 = 0，p <0.01），住院时间短（WMD：2，95％CI：1.18至2.82，I2 = 82％，p <0.01）经腹腔镜肾上腺切除术。并发症发生率（OR：1.58，95％CI：0.58至4.33，I2 = 0； p = 0.38）或血液动力学危象的发生率（OR：0.74，95％CI：0.19至2.94， p = 0.67）。结论腹膜后肾上腺切除术比嗜铬细胞瘤患者的经腹腔入路术更好。并发症发生率（OR：1.58，95％CI：0.58至4.33，I2 = 0； p = 0.38）或血液动力学危象的发生率（OR：0.74，95％CI：0.19至2.94， p = 0.67）。结论腹膜后肾上腺切除术比嗜铬细胞瘤患者经腹膜入路术围手术期效果更好。并发症发生率（OR：1.58，95％CI：0.58至4.33，I2 = 0； p = 0.38）或血液动力学危象的发生率（OR：0.74，95％CI：0.19至2.94， p = 0.67）。结论腹膜后肾上腺切除术比嗜铬细胞瘤患者经腹膜入路术围手术期效果更好。