Laparoendoscopic single site, laparoscopic or open surgery for adrenal tumors: Selecting the optimal approach

Table 3 Summary of the most recent meta-analyses comparing laparoscopic techniques for adrenalectomy

Ref.	RAL-A vs MI-A	TL-A vs RL-A	LESS-A vs MI-A
	Brandao et al[30]	Nigri et al[27]	Wang et al[41]
n	600	1205	443
Mean tumor size (cm)	3.86, 3.78	4.0, 3.3	2.7, 3.43
(Odds ratio, CI)	NA	0.48 (-0.21-1.18)	- 0.69 (-1.11--0.26)
P-value	NS	0.17	0.002
Mean operating time (min)	175, 148	132, 136	113.1, 92.7
(Estimate, CI)	5.88 (-6.02-17.79)	-11.07 (-41.38-19.24)	14.97 (4.69-25.24)
P-value	0.33	0.47	0.004
Mean EBL (mL)	44, 69	115, 85	74.2, 79.7
(Estimate, CI)	-18.21 (-29.11--7.32)	29.7 (-10.32-69.72)	-1.4 (-9.72-6.91)
P-value	< 0.0001	0.15	0.74
Mean LOS	3.78, 3.17	6.4, 5.5	3.82, 4.38
(Estimate, CI)	-0.43 (-0.56--0.30)	0.66 (-0.11-1.43)	-0.5(-1.02-0.02)
P-value	< 0.0001	0.09	0.06
Mean % conversion rate	4.4, 7.1	7.23, 7.74	7.8, 1.2
(Odds ratio, CI)	0.82 (0.39-1.75)	NA	4.66 (0.88-24.64)
P-value	0.61	NA	0.07
Mean % complication rate	3.6, 6.8	8, 6	14.2, 10.1
(Odds ratio, CI)	-0.04 (-0.07--0.00)	0.923 (0.58-1.46)	1.83 (0.88-3.81)
P-value	0.05	0.73	0.1

RAL-A: Robot-assisted laparoscopic adrenalectomy; MI-A: Minimally-invasive adrenalectomy; TL-A: Transpeitoneal laparoscopic adrenalectomy; RL-A: Retroperitoneal laparoscopic adrenalectomy; LESS-A: Laparoendoscopic single-site adrenalectomy; EBL: Estimated blood loss; LOS: Length of hospital stay.