Fu SQ, Wang SY, Chen Q, Liu YT, Li ZL, Sun T. Laparoscopic versus open surgery for pheochromocytoma: a meta-analysis. BMC Surg. 2020 Jul 25;20(1):167.
Results: Fourteen studies involving 626 patients were included in this meta-analysis. LS was associated with lower rates of intraoperative haemodynamic instability (IHD) [odds ratio (OR) = 0.61, 95% CI: 0.37 to 1.00, P = 0.05], less intraoperative blood loss [weighted mean difference (WMD) = – 115.27 ml, 95% confidence interval (CI): – 128.54 to – 101.99, P < 0.00001], lower blood transfusion rates [OR = 0.33, 95% CI: 0.21 to 0.52, P < 0.00001], earlier ambulation (WMD = – 1.57 d, 95% CI: – 1.97 to – 1.16, P < 0.00001) and food intake (WMD = – 0.98 d, 95% CI: – 1.36 to – 0.59, P < 0.00001), shorter drainage tube indwelling time (WMD = – 0.51 d, 95% CI: – 0.96 to – 0.07, P = 0.02) and postoperative stay (WMD = – 3.17 d, 95% CI: – 4.76 to – 1.58, P < 0.0001), and lower overall complication rates (OR = 0.56, 95% CI: 0.35 to 0.88, P = 0.01). However, no significant differences in operative time, postoperative blood pressure control, rates of severe complications, postoperative hypotension or cardiovascular disease (CVD) were found between the two groups.
Conclusions: LS is safe and effective for PHEO resection. Compared with OS, LS caused less IHD, providing an equal chance to cure hypertension while also yielding a faster and better postoperative recovery.
Surgical Focus 