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| Verfasst von: | Heger, Patrick [VerfasserIn]  |
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| | Probst, Pascal [VerfasserIn] |
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| | Hüttner, Felix [VerfasserIn] |
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| | Goossen, Käthe [VerfasserIn] |
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| | Proctor, Tanja [VerfasserIn] |
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| | Müller, Beat P. [VerfasserIn] |
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| | Strobel, Oliver [VerfasserIn] |
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| | Büchler, Markus W. [VerfasserIn] |
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| | Diener, Markus K. [VerfasserIn] |
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| Titel: | Evaluation of open and minimally invasive adrenalectomy |
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| Titelzusatz: | a systematic review and network meta-analysis |
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| Verf.angabe: | Patrick Heger, Pascal Probst, Felix J. Hüttner, Käthe Gooßen, Tanja Proctor, Beat P. Müller-Stich, Oliver Strobel, Markus W. Büchler, Markus K. Diener |
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| E-Jahr: | 2017 |
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| Jahr: | 20 June 2017 |
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| Umfang: | 12 S. |
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| Fussnoten: | Published online: 20 June 2017 ; Gesehen am 24.10.2018 |
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| Titel Quelle: | Enthalten in: World journal of surgery |
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| Ort Quelle: | [Hoboken, New Jersey : Wiley, 1977 |
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| Jahr Quelle: | 2017 |
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| Band/Heft Quelle: | 41(2017), 11, Seite 2746-2757 |
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| ISSN Quelle: | 1432-2323 |
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| Abstract: | Background Adrenalectomy can be performed via open and various minimally invasive approaches. The aim of this systematic review was to summarize the current evidence on surgical techniques of adrenalectomy. Methods Systematic literature searches (MEDLINE, EMBASE, Web of Science, Cochrane Library) were conducted to identify randomized controlled trials (RCTs) and controlled clinical trials (CCTs) comparing at least two surgical procedures for adrenalectomy. Statistical analyses were performed, and meta-analyses were conducted. Furthermore, an indirect comparison of RCTs and a network meta-analysis of CCTs were carried out for each outcome.Results Twenty-six trials (1710 patients) were included. Postoperative complication rates did not show differences for open and minimally invasive techniques. Operation time was significantly shorter for open adrenalectomy than for the robotic approach (p \ 0.001). No differences were found between laparoscopic and robotic approaches. Network meta-analysis showed open adrenalectomy to be the fastest technique. Blood loss was significantly reduced in the robotic arm compared with open and laparoscopic adrenalectomy (p = 0.01). Length of hospital stay (LOS) was significantly lower after conventional laparoscopy than open adrenalectomy in CCTs (p \ 0.001). Furthermore, both retroperitoneoscopic (p \ 0.001) and robotic access (p \ 0.001) led to another significant reduction of LOS compared with conventional laparoscopy. This difference was not consistent in RCTs. Network meta-analysis revealed the lowest LOS after retroperitoneoscopic adrenalectomy. Conclusion Minimally invasive adrenalectomy is safe and should be preferred over open adrenalectomy due to shorter LOS, lower blood loss, and equivalent complication rates. The retroperitoneoscopic access features the shortest LOS and operating time. Further high-quality RCTs are warranted, especially to compare the posterior retroperitoneoscopic and the transperitoneal robotic approach. |
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| DOI: | doi:10.1007/s00268-017-4095-3 |
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| URL: | Bitte beachten Sie: Dies ist ein Bibliographieeintrag. Ein Volltextzugriff für Mitglieder der Universität besteht hier nur, falls für die entsprechende Zeitschrift/den entsprechenden Sammelband ein Abonnement besteht oder es sich um einen OpenAccess-Titel handelt.
Volltext: http://dx.doi.org/10.1007/s00268-017-4095-3 |
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| | Volltext: http://link.springer.com/10.1007/s00268-017-4095-3 |
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| | DOI: https://doi.org/10.1007/s00268-017-4095-3 |
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| Datenträger: | Online-Ressource |
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| Sprache: | eng |
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| K10plus-PPN: | 1582269424 |
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| Verknüpfungen: | → Zeitschrift |
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Evaluation of open and minimally invasive adrenalectomy / Heger, Patrick [VerfasserIn]; 20 June 2017 (Online-Ressource)
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