Peri- and postoperative outcomes of laparoscopic adrenalectomy in nonobese versus obese patients: a systematic review and meta-analysis.

Introduction: Obesity is generally thought to increase the difficulty and complications of surgery. Laparoscopic adrenalectomy has become the standard operation for adrenal tumors at present. Aim: To assess whether laparoscopic adrenalectomy (LA) can be used for obese patients with adrenal tumor. Material and methods: We systematically searched PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), and Science databases and Cochrane Library, and the search time is up to January 2022. We used STATA 16.0 and RevMan 5.4 software for data processing and statistical analysis. Results: Eight studies were included in the meta-analysis. The meta-analysis results showed that compared with the nonobese group, the obese group had a significantly longer operation time (OT) (weighted mean difference (WMD): -10.02, 95% confidence interval (CI): -19.16 to 0.87, p = 0.03). It also had higher estimated blood loss (WMD: -13.15, 95% CI: -35.92 to 9.63, p = 0.26) and conversion rate (odds ratio (OR): 0.70, 95% CI: 1.31 to 1.60, p = 0.40), longer length of hospital stay (LOS) (WMD: -0.04, 95% CI: -0.47 to 0.39, p = 0.86), and a higher number of complications (odds ratio (OR) = 0.71, 95% CI: 0.49 to 1.02, p = 0.06), but these differences were not statistically significant. Additionally, in subgroup analysis longer OT (p = 0.0001) and LOS (p = 0.007) were associated with retroperitoneal laparoscopic adrenalectomy for obesity. Conclusions: Our meta-analysis suggests that LA is feasible and effective in patients with obesity.