Evidence map›Paper›PMID 37145303›Full record

SynthesisLangenbeck's archives of surgery2023

Comparing surgical outcomes of approaches to adrenalectomy - a systematic review and network meta-analysis of randomised clinical trials.

Matthew G Davey, Éanna J Ryan, Noel E Donlon, Odhrán K Ryan, Mohammed Al Azzawi, Michael R Boland, Michael J Kerin, Aoife J Lowery

Open access · hybridAbstract readSystematic ReviewNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Langenbeck's archives of surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
4.1field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Robotic Submesocolic Left Adrenalectomy: The Evolution of Delbet Approach.The international journal of medical robotics + computer assisted surgery : MRCAS · 2025
    Article
  5. A case of aberrant right adrenal vein anatomy.Journal of surgical case reports · 2025
    Article
  6. Article
  7. Review
  8. Article
  9. [Robotic adrenalectomy-current evidence].Chirurgie (Heidelberg, Germany) · 2024
    Review
  10. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Matthew G DaveyDiscipline of Surgery, The Lambe Institute for Translational Research, National University of Ireland, Galway, Galway, H91YR71, Ireland. m.davey7@nuigalway.ie.
Éanna J RyanRoyal College of Surgeons in Ireland, 123 St. Stephens Green, Dublin 2, D02YN77, Ireland.
Noel E DonlonRoyal College of Surgeons in Ireland, 123 St. Stephens Green, Dublin 2, D02YN77, Ireland.
Odhrán K RyanSurgical Professorial Unit, St. Vincent's University Hospital, Elm Park, Dublin 4, D04 T6F4, Ireland.
Mohammed Al AzzawiRoyal College of Surgeons in Ireland, 123 St. Stephens Green, Dublin 2, D02YN77, Ireland.
Michael R BolandRoyal College of Surgeons in Ireland, 123 St. Stephens Green, Dublin 2, D02YN77, Ireland.
Michael J KerinDiscipline of Surgery, The Lambe Institute for Translational Research, National University of Ireland, Galway, Galway, H91YR71, Ireland.
Aoife J LoweryDiscipline of Surgery, The Lambe Institute for Translational Research, National University of Ireland, Galway, Galway, H91YR71, Ireland.
Royal College of Surgeons in Ireland · IEOllscoil na Gaillimhe – University of Galway · IESt. Vincent's University Hospital · IE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNo randomised clinical trials (RCTs) have simultaneously compared the safety of open (OA), transperitoneal laparoscopic (TLA), posterior retroperitoneal (PRA), and robotic adrenalectomy (RA) for resecting adrenal tumours.

aimTo evaluate outcomes for OA, TLA, PRA, and RA from RCTs.

methodsA NMA was performed according to PRISMA-NMA guidelines. Analysis was performed using R packages and Shiny.

resultsEight RCTs with 488 patients were included (mean age: 48.9 years). Overall, 44.5% of patients underwent TLA (217/488), 37.3% underwent PRA (182/488), 16.4% underwent RA (80/488), and just 1.8% patients underwent OA (9/488). The mean tumour size was 35 mm in largest diameter with mean sizes of 44.3 mm for RA, 40.9 mm for OA, 35.5 mm for TLA, and 34.4 mm for PRA (P < 0.001). TLA had the lowest blood loss (mean: 50.6 ml), complication rates (12.4%, 14/113), and conversion to open rates (1.3%, 2/157), while PRA had the shortest intra-operative duration (mean: 94 min), length of hospital stay (mean: 3.7 days), lowest visual analogue scale pain scores post-operatively (mean: 3.7), and was most cost-effective (mean: 1728 euros per case). At NMA, there was a significant increase in blood loss for OA (mean difference (MD): 117.00 ml (95% confidence interval (CI): 1.41-230.00)) with similar blood loss observed for PRA (MD: - 10.50 (95% CI: - 83.40-65.90)) compared to TLA.

conclusionLTA and PRA are important contemporary options in achieving favourable outcomes following adrenalectomy. The next generation of RCTs may be more insightful for comparison surgical outcomes following RA, as this approach is likely to play a future role in minimally invasive adrenalectomy. PROSPERO REGISTRATION: CRD42022301005.

Indexed as

Adrenal Gland NeoplasmsLaparoscopyAdrenalectomyHumansLength of StayMiddle AgedRandomized Controlled Trials as TopicRetroperitoneal SpaceTreatment OutcomeAdrenalectomyAdrenal surgeryOncological outcomesSurgical oncology

Identifiers

PMID37145303
PMCPMC10163131
OpenAlexW4372278970

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.