Ge Si, Wang Zuoping, Li Yunxiang, Zheng Lei, Gan Lijian, Zeng Zhiqiang, Meng Chunyang, Li Kangsen, Ma Jiakai, Wang Deyu, Ren Yuan
Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong 63700, Sichuan, China (S.G., Z.W., Y.L., L.Z., L.G., K.L., J.M., D.W.); Department of Urology, School of Clinical Medicine, Southwest Medical University, Luzhou 646000, Sichuan, China (S.G., Y.L., Z.Z., C.M., Y.R.).
Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong 63700, Sichuan, China (S.G., Z.W., Y.L., L.Z., L.G., K.L., J.M., D.W.).
Acad Radiol. 2025 Jan;32(1):218-235. doi: 10.1016/j.acra.2024.08.007. Epub 2024 Aug 15.
To compare perioperative and oncology outcomes of ablation and partial nephrectomy in small renal masses (SRMs).
We conduct this meta-analysis strictly according to the PRISMA standard, and the quality evaluation follows the AMSTAR standard. Four databases, Embase, PubMed, Cochrane Library, and Web of Science, were systematically searched. The search time range is from database creation to November 2023. Stata16 statistical software was used for statistical analysis. Weighted mean difference (WMD) represented continuity variables, odds ratio or relative risk (OR/RR) represented dichotomies variables, and 95% confidence intervals (95%CI) were calculated.
A total of 27 studies, including 6030 patients. Results showed that patients undergoing partial nephrectomy were younger (WMD = -5.45 years, 95%CI [-7.44, -3.46], P < 0.05), had longer operation time (WMD = 64.91 min, 95%CI [44.47, 85.34], P < 0.05), had longer length of stay (WMD = 2.91 days, 95%CI [2.04, 3.78], P < 0.05), and had more estimated blood loss (WMD = 97.76 ml, 95%CI [69.48, 126.04]. P < 0.05), the overall complication rate was higher (OR = 1.84, 95%CI [1.48, 2.29], P < 0.05), the major complication rate was higher (OR = 1.98, 95%CI [1.36, 2.88], P < 0.05), and the recurrence rate was lower (OR = 0.32, 95%Cl [0.20, 0.50], P < 0.05). However, there were no differences between ablation and partial nephrectomy in cancer-specific survival (CSS) (HR = 2.07, 95%CI [0.61, 7.04], P > 0.05), overall survival (OS) (HR = 1.24, 95%CI [0.58, 2.65], P > 0.05), and recurrence-free survival (RFS) (HR = 2.68, 95%CI [0.91, 7.88], P > 0.05).
Patients undergoing partial nephrectomy are younger, have longer operation time and length of stay, and have higher complication rate. However, there was no significant difference in CSS, OS, and RFS between partial nephrectomy and ablation, but more well-designed, high-quality studies are needed to confirm this.
比较小肾肿块（SRMs）消融术和部分肾切除术的围手术期及肿瘤学结局。
我们严格按照PRISMA标准进行此项荟萃分析，质量评估遵循AMSTAR标准。系统检索了四个数据库，即Embase、PubMed、Cochrane图书馆和Web of Science。检索时间范围为从数据库创建至2023年11月。使用Stata16统计软件进行统计分析。加权平均差（WMD）代表连续性变量，比值比或相对风险（OR/RR）代表二分变量，并计算95%置信区间（95%CI）。
共纳入27项研究，包括6030例患者。结果显示，接受部分肾切除术的患者更年轻（WMD = -5.45岁，95%CI [-7.44, -3.46]，P < 0.05），手术时间更长（WMD = 64.91分钟，95%CI [44.47, 85.34]，P < 0.05），住院时间更长（WMD = 2.91天，95%CI [2.04, 3.78]，P < 0.05），估计失血量更多（WMD = 97.76毫升，95%CI [69.48, 126.04]，P < 0.05），总体并发症发生率更高（OR = 1.84，95%CI [1.48, 2.29]，P < 0.05），主要并发症发生率更高（OR = 1.98，95%CI [1.36, 2.88]，P < 0.05），复发率更低（OR = 0.32，95%Cl [0.20, 0.50]，P < 0.05）。然而，消融术和部分肾切除术在癌症特异性生存率（CSS）（HR = 2.07，95%CI [0.61, 7.04]，P > 0.05）、总生存率（OS）（HR = 1.24，95%CI [0.58, 2.65]，P > 0.05）和无复发生存率（RFS）（HR = 2.68，95%CI [0.91, 7.88]，P > 0.05）方面无差异。
接受部分肾切除术的患者更年轻，手术时间和住院时间更长，并发症发生率更高。然而，部分肾切除术和消融术在CSS、OS和RFS方面无显著差异，但需要更多设计良好、高质量的研究来证实这一点。
