Giordano Alessio, Balla Andrea, Prosperi Paolo, Morales-Conde Salvador, Bergamini Carlo
Emergency Surgery Unit, Department of Emergency and Acceptance, Careggi University Hospital, 50134 Florence, Italy.
Department of General and Digestive Surgery, University Hospital Virgen Macarena, University of Sevilla, 41009 Sevilla, Spain.
J Clin Med. 2025 May 29;14(11):3806. doi: 10.3390/jcm14113806.
The application of robotic adrenalectomy (RA) has been increasing. However, there is still controversy about whether RA is more feasible than laparoscopic adrenalectomy (LA) for pheochromocytoma (PHEO). We conducted a systematic review of published articles between 2013 and 2025 according to the PRISMA statement and the Cochrane Handbook for systematic reviews of interventions. The search was conducted in MEDLINE (PubMed, Scholar, and Cochrane databases). : Overall, seven studies including 879 patients (RA 358; LA 521) were included. RA might have larger tumor size (MD -0.66, 95% CI -1.18 to 0.13; < 0.00001) but not for BMI patients (MD -0.24, 95% CI -1.44 to 0.96; < 0.00001). There were no statistically significant differences in intraoperative complication, conversion to open surgery, postoperative complications, transfusion rate, and perioperative hemodynamic outcomes with the exception of a higher lowest systolic blood pressure in the LA group (MD -1.09, 95% CI -2.35 to 0.18; < 0.00001). Moreover, estimated blood loss (MD 29.52, 95% CI 4.19 to 54.84; < 0.00001), operative time (MD 3.85, 95% CI -16.11 to 23.80; < 0.00001), and the length of hospital stay were in favor of RA (MD 0.42, 95% CI 0.09 to 0.74; < 0.0001). : Both LA and RA are safe and feasible approaches for adrenalectomy in the case of pheochromocytoma. RA seems to have better perioperative results, but further prospective randomized control studies are required to draw definitive conclusions.
机器人肾上腺切除术（RA）的应用一直在增加。然而，对于嗜铬细胞瘤（PHEO），RA是否比腹腔镜肾上腺切除术（LA）更可行仍存在争议。我们根据PRISMA声明和Cochrane干预措施系统评价手册，对2013年至2025年发表的文章进行了系统评价。检索在MEDLINE（PubMed、Scholar和Cochrane数据库）中进行。总体而言，纳入了7项研究，共879例患者（RA组358例；LA组521例）。RA组的肿瘤可能更大（MD -0.66，95%CI -1.18至0.13；P<0.00001），但体重指数（BMI）方面两组无差异（MD -0.24，95%CI -1.44至0.96；P<0.00001）。除LA组最低收缩压较高外（MD -1.09，95%CI -2.35至0.18；P<0.00001），两组在术中并发症、中转开放手术、术后并发症、输血率和围手术期血流动力学结果方面无统计学显著差异。此外，估计失血量（MD 29.52，95%CI 4.19至54.84；P<0.00001）、手术时间（MD 3.85，95%CI -16.11至23.80；P<0.00001）和住院时间方面RA组更具优势（MD 0.42，95%CI 0.09至0.74；P<0.0001）。LA和RA对于嗜铬细胞瘤患者的肾上腺切除术都是安全可行的方法。RA似乎具有更好的围手术期结果，但需要进一步的前瞻性随机对照研究来得出明确结论。
