| Objective:Adrenalectomy is the first line of treatment in unilateral aldosterone-producing adenoma.Whether adrenalectomy should be performed using a cortex-sparing technique(partial adrenalectomy)or total adrenalectomy remains debatable.Therefore,this meta-analysis aims to evaluate the safety and effectiveness of partial adrenalectomy(PA)to total adrenalectomy(TA)by comparing perioperative and functional outcomes.Methods:A systematic search was performed across Pubmed,Embase,Web of Science,Cochrane Library database for RCTs and non-RCTs comparing PA and TA on unilateral aldosterone-producing adenoma.The main outcomes analyzed were the perioperative and postoperative effectiveness.In addition,weighted mean difference(WMD)or odds ratio(OR)with 95 percent confidence intervals of continuous and dichotomous variables are presented.Results:Two RCTs and five non-RCTs trials,including 834 patients were identified and included in the meta-analysis.PA was associated with statistically significant shorter hospital stay(WMD-0.51 days,95%CI-0.87,-0.14;P=0.007),shorter operative time(WMD-15.54 min,95%CI-25.12,-5.97 P=0.001)and lower overall complications(OR 0.52,95%CI 0.32,0.85;P=0.009)compared to TA.There was no statistical significance in postoperative effectiveness,including postoperative blood pressure,potassium,hypokalemia,ARR and renin between TA and PA.Conclusions:PA seems to have advantages over TA.The surgical outcomes were comparable in TA and PA.The hospital stay,operative time and overall complications may be reduced.When technically feasible,PA might be considered as a better treatment for unilateral aldosterone-producing adenoma. |
