{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T04:42:11Z","timestamp":1790656931919,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,8,27]],"date-time":"2020-08-27T00:00:00Z","timestamp":1598486400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,8,27]],"date-time":"2020-08-27T00:00:00Z","timestamp":1598486400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2020,8,27]],"date-time":"2020-08-27T00:00:00Z","timestamp":1598486400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Two main minimal access adrenalectomy techniques are available: laparoscopic transperitoneal (LTA) and posterior retroperitoneoscopic adrenalectomy (PRA). This study aims to compare these approaches in an updated meta\u2010analysis of randomised controlled (RCT) and non\u2010randomised comparative (NRT) trials.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic search of comparative LTA and PRA studies was performed. Standard demographic and surgical data were recorded. Outcome measures compared included: operative time, estimated blood loss (EBL), conversion to open, post\u2010operative pain, time to oral intake and ambulation, early morbidity, hospital length of stay (HLOS) and mortality. Quality of RCTs and NRTs was assessed using Cochrane and ROBINS\u2010I, respectively, and heterogeneity using the <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> test. Dichotomous and continuous variables were compared using odds ratios and mean\/standard difference. Studies were then combined using the Mantel\u2013Haenszel method. Meta\u2010analysis was performed by fixed\u2010 and random\u2010effect models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Following exclusions, 12 studies were included in the analysis: 3 RCTs and 9\u00a0NRTs. These reported a total of 775 patients: 341 (44%) PRA and 434 (56%) LTA. Demographics were similar except for tumour size which was smaller (by 0.78\u00a0cm) in PRA (<jats:italic>p<\/jats:italic>\u2009=\u20090.003). Significant differences in outcome were seen in EBL (18\u00a0mls less in PRA, <jats:italic>p<\/jats:italic>\u2009=\u20090.006), time to oral intake (3.4 h sooner in PRA <jats:italic>p<\/jats:italic>\u2009=\u20090.009) and HLOS (shorter in PRA by 0.84\u00a0day, <jats:italic>p<\/jats:italic>\u2009=\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This analysis demonstrates that while PRA tends to be performed for smaller tumours it allows for less EBL, earlier post\u2010operative oral intake and shorter hospital stays. In appropriately selected patients, it represents an invaluable tool in the endocrine surgeon's armamentarium.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-020-05759-w","type":"journal-article","created":{"date-parts":[[2020,8,27]],"date-time":"2020-08-27T17:03:41Z","timestamp":1598547821000},"page":"168-179","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":52,"title":["Posterior Retroperitoneoscopic Versus Laparoscopic Transperitoneal Adrenalectomy: A Systematic Review by an Updated Meta\u2010Analysis"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7773-2291","authenticated-orcid":false,"given":"Paschalis","family":"Gavriilidis","sequence":"first","affiliation":[{"name":"Department of Endocrine and Thyroid Surgery, Imperial College Healthcare NHS Trust Hammersmith Hospital Du Cane Road W12 OHS London UK"},{"name":"Department of HPB Surgery, Imperial College Healthcare NHS Trust Hammersmith Hospital Du Cane Road W12 OHS London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Camenzuli","sequence":"additional","affiliation":[{"name":"Department of Endocrine and Thyroid Surgery, Imperial College Healthcare NHS Trust Hammersmith Hospital Du Cane Road W12 OHS London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Paspala","sequence":"additional","affiliation":[{"name":"Department of HPB Surgery, Imperial College Healthcare NHS Trust Hammersmith Hospital Du Cane Road W12 OHS London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aimee N.","family":"Di Marco","sequence":"additional","affiliation":[{"name":"Department of Endocrine and Thyroid Surgery, Imperial College Healthcare NHS Trust Hammersmith Hospital Du Cane Road W12 OHS London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fausto F.","family":"Palazzo","sequence":"additional","affiliation":[{"name":"Department of Endocrine and Thyroid Surgery, Imperial College Healthcare NHS Trust Hammersmith Hospital Du Cane Road W12 OHS London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,8,27]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199210013271417"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.5980\/jpnjurol1989.83.1130"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010199709000\u201000003"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658\u2010200012000\u201000008"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s002689900117"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464\u2010013\u20103009\u20101"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.8921"},{"key":"e_1_2_12_9_1","article-title":"Transperitoneal versus retroperitoneal laparoscopic adrenalectomy for adrenal tumours in adults","volume":"12","author":"Arezzo A","year":"2018","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"key":"e_1_2_12_11_1","unstructured":"HigginsJPT GreensS(2019) Cochrane handbook for systematic reviews of interventions version 5.1 [update July 2019].The Cochrane Collaboration 2011.www.cochrane.handbook.org"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102288\u20105\u201013"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010017\u20104095\u20103"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000000982"},{"key":"e_1_2_12_17_1","first-page":"160","article-title":"Laparoscopic adrenalectomy: lateral transperitoneal versus posterior retroperitoneal approach\u2010prospective randomized trial","volume":"14","author":"Kozlowski T","year":"2019","journal-title":"Wideochir Inne Tech Maloinwazyjne"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002603"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1464\u2010410X.2002.02845.x"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2008.08.025"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2011.07.004"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010013\u20102326\u20109"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLE.0b013e31828fa71f"},{"key":"e_1_2_12_24_1","doi-asserted-by":"crossref","unstructured":"OttlakanA PasztA SimonkaZ AbrahamS BordaB VasMet al. Laparoscopic transperitoneal and retroperitoneal adrenalectomy: a 20\u2010year single\u2010institution experience with an analysis of the learning curve and tumor size [lap transper and retroper adrenalectomy].Surg Endosc(2020)10.1007\/s00464\u2010019\u201007337\u20101319537267644518","DOI":"10.1007\/s00464-019-07337-1"},{"key":"e_1_2_12_25_1","unstructured":"TuncelA LangenhuijsenJ ErkanA MikhaylikovT ArslanM AslanYet al. 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