Laparoscopic cryoablation vs. percutaneous cryoablation for treatment of small renal masses: a systematic review and meta-analysis
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Kehua Jiang1,2,*, Kun Tang1,*, Xiaolin Guo1, Haoran Liu1, Hongbo Chen2, Zhiqiang Chen1, Hua Xu1 and Zhangqun Ye1
1 Department of Urology, Institute of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
2 Department of Urology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi, China
* These authors have contributed equally to this work
Hua Xu, email:
Keywords: Laparoscopic cryoablation; percutaneous cryoablation; small renal masses; meta-analysis
Received: July 22, 2016 Accepted: January 23, 2017 Published: February 10, 2017
CONTEXT: Laparoscopic cryoablation (LCA) and percutaneous cryoablation(PCA) have been used on patients with small renal masses(SRMs) for many years. However, clinical studies assessing their feasibility and safety have reported contradictory outcomes. This systematic evaluation was performed to obtain comprehensive evidence with regard to the feasibility and safety of PCA compared with LCA.
METHODS: A systematic search of Embase, Pubmed, Medline, the Cochrane Library were performed to identify studies that compared LCA with PCA were published up to Mar 2016. Outcomes of interest included perioperative, pathologic variables, and complications.
RESULTS: Thirteen studies estimating LCA versus PCA were included for meta-analysis. Patients undergoing PCA were significantly older(WMD = -0.16 years; P = 0.01) and patients with posterior tumors were significantly prefer undergoing PCA than LCA(OR = 0.23; P = 0.0007), whereas patients with anterior tumors were significantly prefer undergoing LCA(OR = 3.82; P = 0.02). although PCA was associated with shorter hospital stay(WMD = 1.17 days; P < 0.0001) and higher incidence rate of perirenal hematoma(OR = 0.18; P < 0.0001). All the other analyzed parameters were similar, regardless of the surgical approach.
CONCLUSIONS: Patients undergoing PCA have shorter hospital stay and PCA was more frequently used in older patients and posterior tumors. Whereas LCA was associated with lower incidence rate of perirenal hematoma. Further multicenter, prospective and long-term follow-up RCTs are required to verify these findings.
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