Laparoscopic versus percutaneous cryotherapy for renal tumours: a systematic review and meta-analysis

Aboumarzouk, O. M., Ismail, M., Breen, D., Van Strijen, M., Garnon, J., Lagerveld, B., Nielsen, T. and Keeley, F. (2018) Laparoscopic versus percutaneous cryotherapy for renal tumours: a systematic review and meta-analysis. Journal of Endourology, 32(3), pp. 177-183. (doi:10.1089/end.2017.0791) (PMID:29212363)

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Abstract

Background: Cryoablation has emerged as an alternative to the more invasive partial nephrectomy for small renal masses. The approach can be carried out by two techniques, either laparoscopic cryoablation (LCA) or percutaneous cryoablation, (PCA) with CT guidance. We aimed to compare between the two procedures. Materials and Methods: A systematic review and meta-analysis was conducted, including studies comparing the two techniques. Outcomes included incomplete ablation, late local recurrence, cancer-specific survival, procedure time, transfusion rates, hospital stay, and complications. Results: A total of 1475 patients were included, 788 patients in the laparoscopic group and 687 patients in the percutaneous group. There was statistical difference favoring the laparoscopic group with regard to having less incomplete ablation (p = 0.0008) and higher cancer-specific survival patients (p = 0.04). However, there was longer hospital stays in the LCA group (p < 0.00001) and was found to be more costly than the PCA group. There was significantly more Clavien-I complications in the PCA group (p = 0.001) and more Clavien-III complications in the LCA group (p = 0.001). Otherwise, there were no differences in any other outcome parameter. Conclusion: LCA was found to have less incomplete tumor ablation rates and higher cancer-specific survival rates, however, higher hospitalization time, more major complications (Clavien III), and was costlier compared with PCA.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Aboumarzouk, Mr Omar
Authors: Aboumarzouk, O. M., Ismail, M., Breen, D., Van Strijen, M., Garnon, J., Lagerveld, B., Nielsen, T., and Keeley, F.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:Journal of Endourology
Publisher:Mary Ann Liebert
ISSN:0892-7790
ISSN (Online):1557-900X
Published Online:06 December 2017
Copyright Holders:Copyright © 2017 Mary Anne Liebert Inc.
First Published:First published in Journal of Endourology 32(3):177-183
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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