Laparoscopic partial nephrectomy versus 1aparoscopic cryoablation for the small renal tumors:a meta-analysis of safety and efifcacy
10.3969/j.issn.1007-1989.2016.12.011
- VernacularTitle:腹腔镜肾部分切除术与腹腔镜冷冻消融术治疗小肾肿瘤的安全性和疗效的Meta分析
- Author:
Qiang GUO
;
Ruimin REN
;
Jingyu WANG
;
Jianwen LI
;
Jiandong ZHANG
;
Yangang ZHANG
- Keywords:
laparoscopic partial nephrectomy;
1aparoscopic cryoablation;
small renal tumors;
Meta-analysis
- From:
China Journal of Endoscopy
2016;22(12):55-61
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the safety and efifcacy of Laparoscopic partial nephrectomy (LPN) versus 1aparoscopic cryoablation (LCA) for the small renal tumors (SRMs).Methods The databases of PubMed, SCI, Ovid, the Cochrane Library, CNKI, CBM, VIP and Wangfang Data were searched to controlled clinical trial about LPN versus LCA for the treatment of small renal tumor. The retrieval time span was from inception to Apr 2016. The studies were screened according to the inclusion and exclusion criteria, the date were extracted and the quality was evaluated by 2 reviewers independently. And then the Meta-analysis was conducted using RevMan 5.3 software.Results 9 studies were included, and 748 cases were involved. The meta-analysis showed that comparing with LPN, the operation time of LCA was shorter [MD = 42.75, 95 % CI (12.19~73.31),P = 0.006], less intraoperative blood loss [MD = 190.73, 95 % CI (126.67~254.78),P = 0.000], shortening hospital stay [MD = 2.23, 95 % CI (0.17~4.28),P = 0.030], lower transfusion rate [OR^ = 3.54, 95 % CI (1.18~10.59),P = 0.020], lower rate of postoperative glomerular ifltration levels [MD = 10.30, 95 % CI (5.38~15.24),P = 0.000], less complications [OR^= 3.90, 95 % CI (1.84 ~ 8.24),P = 0.000], higher risk of local recurrence [OR^ = 0.13, 95 % CI (0.04 ~ 0.44),P =0.000], higher risk of distant metastases [OR^ = 0.16, 95 % CI (0.03 ~ 0.78),P = 0.020], but there were no signiifcant differences in postoperative creatinine rise and transfusion rate (P > 0.05).Conclusions LCA has advantage in perioperative period results and protect renal function. But LCA has a higher local recurrence and distant metastasis risk, short-term and medium-term efficacy considerably, long-term effect is not clear, therefore, in the choice of surgical cases still need to be careful.
