The international journal of medical robotics + computer assisted surgery : MRCAS · 2026
Does Robotic Adrenalectomy Outperform Laparoscopic Approaches in Obese Patients? A Systematic Review and Subgroup Meta-Analysis of 1,107 Patients.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Abdelsamad Ahmed, Badie Youssef, Elfakharany Mohamed, Elatrosh Mohamed, Elgohary Mohamed, Elmaghraby Eslam, Gebauer Florian, Langenbach Ralf Mike, Mohamed Khaled
Аннотация
BACKGROUND: Obesity poses technical challenges in adrenalectomy. Robotic adrenalectomy (RA) offers advantages over laparoscopic adrenalectomy (LA), but evidence in obese patients remains limited.
METHODS: A meta-analysis of comparative studies through 2025 assessed perioperative outcomes of RA versus LA, with subgroup analyses by body habitus (obese vs. non-obese) and surgical approach (lateral transabdominal [LT] vs. posterior retroperitoneal [PR]). Primary outcomes included operative time (OT), blood loss (EBL), hospital stay (LOHS), complications, conversion, and mortality. Study quality was evaluated using the Newcastle-Ottawa Scale, and certainty was assessed using the GRADE approach.
RESULTS: Eight studies (1107 patients) were included. RA was associated with reduced EBL (p < 0.001) and shorter LOHS (p < 0.001), with no other significant differences. Subgroup analysis showed shorter LOHS in non-obese LA patients (p = 0.03). PR showed a shorter LOHS (p = 0.001) compared with LT.
CONCLUSIONS: RA provides perioperative benefits, particularly reduced blood loss and shorter hospital stay, without compromising safety.
METHODS: A meta-analysis of comparative studies through 2025 assessed perioperative outcomes of RA versus LA, with subgroup analyses by body habitus (obese vs. non-obese) and surgical approach (lateral transabdominal [LT] vs. posterior retroperitoneal [PR]). Primary outcomes included operative time (OT), blood loss (EBL), hospital stay (LOHS), complications, conversion, and mortality. Study quality was evaluated using the Newcastle-Ottawa Scale, and certainty was assessed using the GRADE approach.
RESULTS: Eight studies (1107 patients) were included. RA was associated with reduced EBL (p < 0.001) and shorter LOHS (p < 0.001), with no other significant differences. Subgroup analysis showed shorter LOHS in non-obese LA patients (p = 0.03). PR showed a shorter LOHS (p = 0.001) compared with LT.
CONCLUSIONS: RA provides perioperative benefits, particularly reduced blood loss and shorter hospital stay, without compromising safety.