Oncologic and perioperative outcomes of laparoscopic versus open radical nephrectomy for the treatment of renal tumor (> 7 cm): a systematic review and pooled analysis of comparative outcomes.
World J Surg Oncol
; 21(1): 35, 2023 Feb 06.
Article
en En
| MEDLINE
| ID: mdl-36747217
ABSTRACT
OBJECTIVE:
Systematic evaluation of the effectiveness and safety of laparoscopic radical nephrectomy (LRN) for renal tumor (>7 cm).METHODS:
The databases PubMed, Scopus, SinoMed, ScienceDirect, and Google Scholar were systematically searched for trials up to November 2022. The pooled results were evaluated by weighted mean difference (WMD), odds ratio (OR), and hazard ratio (HR).RESULTS:
This meta-analysis (18 trials) demonstrated that compared to open radical nephrectomy (ORN), LRN had a longer operative time (OT) (WMD=15.99, 95% CI 6.74 to 25.24, p = 0.0007), lower estimated blood loss (EBL) (WMD = -237.07, 95% CI -300.02 to -174.12, p < 0.00001), lower transfusion rates (OR = 0.37, 95% CI 0.24 to 0.55, p < 0.00001), and shorter length of stay (LOS) (WMD = -2.95, 95% CI -3.86 to -2.03, p < 0.00001). No statistically relevant differences were found in overall survival (OS) (HR = 1.04, 95% CI 0.81 to 1.35, p = 0.76), cancer-specific survival (CSS) (HR = 1.28, 95% CI 0.97 to 1.68, p = 0.08), progression-free survival (PFS) (HR = 1.20, 95% CI 0.97 to 1.48, p = 0.1), recurrence-free survival (RFS) (OR = 1.27, 95% CI 0.89 to 1.81, p = 0.56), local recurrence rate (OR = 0.85, 95% CI 0.42 to 1.71, p = 0.65), and intraoperative and postoperative complications.CONCLUSION:
For patients with renal tumors (> 7 cm), LRN has specific perioperative advantages over ORN (LOS, EBL, and transfusion rates). However, the OT was prolonged in the LRN group. In addition, no differences in complication or oncological outcomes (OS, CSS, PFS, RFS, and local recurrence rate) were reported. TRIAL REGISTRATION PROSPERO CRD42022367114.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Carcinoma de Células Renales
/
Laparoscopía
/
Neoplasias Renales
Tipo de estudio:
Etiology_studies
/
Systematic_reviews
Límite:
Humans
Idioma:
En
Revista:
World J Surg Oncol
Año:
2023
Tipo del documento:
Article
País de afiliación:
China