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Robot assisted adrenalectomy: a handy tool or glorified obsession?

Identifieur interne : 000064 ( Pmc/Curation ); précédent : 000063; suivant : 000065

Robot assisted adrenalectomy: a handy tool or glorified obsession?

Auteurs : Mrinal Pahwa

Source :

RBID : PMC:4523626

Abstract

Robotic surgery has recently expanded its horizon in urology apart from radical prostatectomy, one of them being adrenalectomy. Till now, laparoscopic adrenalectomy has established itself as the procedure of choice for benign adrenal disorders. Brandao et al. have recently accomplished a thorough systematic review and meta-analysis of nine trials comparing laparoscopic and robotic adrenalectomy. There was no significant difference between the two groups in terms of conversion rate [odds ratio (OR): 0.82; 95% CI, 0.39-1.75; P=0.61] and operative time (WMD: 5.88; 95% CI, −6.02 to 17.79; P=0.33). There was a significantly longer hospital stay in the conventional laparoscopic group (WMD: −0.43; 95% CI, −0.56 to −0.30; P<0.00001), as well as a higher estimated blood loss (WMD: −18.21; 95% CI, −29.11 to −7.32; P=0.001). There was also no statistically significant difference in terms of postoperative complication rate. The authors seem to support the use of robot for adrenalectomy. However, robotic surgery suffers from cost issues and some technical drawbacks that limit its use in routine practice. Larger and appropriately powered randomized controlled trials are needed to establish and justify its use for performing adrenalectomy.


Url:
DOI: 10.3978/j.issn.2227-684X.2015.05.01
PubMed: 26312212
PubMed Central: 4523626

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PMC:4523626

Le document en format XML

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<p>Robotic surgery has recently expanded its horizon in urology apart from radical prostatectomy, one of them being adrenalectomy. Till now, laparoscopic adrenalectomy has established itself as the procedure of choice for benign adrenal disorders. Brandao
<italic>et al</italic>
. have recently accomplished a thorough systematic review and meta-analysis of nine trials comparing laparoscopic and robotic adrenalectomy. There was no significant difference between the two groups in terms of conversion rate [odds ratio (OR): 0.82; 95% CI, 0.39-1.75; P=0.61] and operative time (WMD: 5.88; 95% CI, −6.02 to 17.79; P=0.33). There was a significantly longer hospital stay in the conventional laparoscopic group (WMD: −0.43; 95% CI, −0.56 to −0.30; P<0.00001), as well as a higher estimated blood loss (WMD: −18.21; 95% CI, −29.11 to −7.32; P=0.001). There was also no statistically significant difference in terms of postoperative complication rate. The authors seem to support the use of robot for adrenalectomy. However, robotic surgery suffers from cost issues and some technical drawbacks that limit its use in routine practice. Larger and appropriately powered randomized controlled trials are needed to establish and justify its use for performing adrenalectomy.</p>
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<pmc article-type="editorial">
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<journal-id journal-id-type="nlm-ta">Gland Surg</journal-id>
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<article-title>Robot assisted adrenalectomy: a handy tool or glorified obsession?</article-title>
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<name>
<surname>Pahwa</surname>
<given-names>Mrinal</given-names>
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<aff id="aff1">Department of Urology and Renal Transplantation, Sir Ganga Ram Hospital, New Delhi,
<country>India</country>
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<author-notes>
<corresp id="cor1">
<italic>Correspondence to:</italic>
Mrinal Pahwa. Department of Urology and Renal Transplantation, Sir Ganga Ram Hospital, New Delhi, India. Email:
<email xlink:href="drmrinalpahwa@gmail.com">drmrinalpahwa@gmail.com</email>
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<pmc-comment>Fake ppub date generated by PMC from publisher pub-date/@pub-type='epub-ppub' </pmc-comment>
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<month>8</month>
<year>2015</year>
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<volume>4</volume>
<issue>4</issue>
<fpage>279</fpage>
<lpage>282</lpage>
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<date date-type="received">
<day>22</day>
<month>4</month>
<year>2015</year>
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<date date-type="accepted">
<day>29</day>
<month>4</month>
<year>2015</year>
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<copyright-statement>2015 Gland Surgery. All rights reserved.</copyright-statement>
<copyright-year>2015</copyright-year>
<copyright-holder>Gland Surgery.</copyright-holder>
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<abstract>
<p>Robotic surgery has recently expanded its horizon in urology apart from radical prostatectomy, one of them being adrenalectomy. Till now, laparoscopic adrenalectomy has established itself as the procedure of choice for benign adrenal disorders. Brandao
<italic>et al</italic>
. have recently accomplished a thorough systematic review and meta-analysis of nine trials comparing laparoscopic and robotic adrenalectomy. There was no significant difference between the two groups in terms of conversion rate [odds ratio (OR): 0.82; 95% CI, 0.39-1.75; P=0.61] and operative time (WMD: 5.88; 95% CI, −6.02 to 17.79; P=0.33). There was a significantly longer hospital stay in the conventional laparoscopic group (WMD: −0.43; 95% CI, −0.56 to −0.30; P<0.00001), as well as a higher estimated blood loss (WMD: −18.21; 95% CI, −29.11 to −7.32; P=0.001). There was also no statistically significant difference in terms of postoperative complication rate. The authors seem to support the use of robot for adrenalectomy. However, robotic surgery suffers from cost issues and some technical drawbacks that limit its use in routine practice. Larger and appropriately powered randomized controlled trials are needed to establish and justify its use for performing adrenalectomy.</p>
</abstract>
<kwd-group kwd-group-type="author">
<title>Keywords: </title>
<kwd>Robotic assisted</kwd>
<kwd>robotic</kwd>
<kwd>adrenalectomy</kwd>
<kwd>laparoscopic adrenalectomy</kwd>
<kwd>phaeochromocytoma</kwd>
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