Int J Surg. 2023 Mar 15. doi: 10.1097/JS9.0000000000000321. Online ahead of print.
OBJECTIVE: comparison of the perioperative outcomes of laparoscopic retroperitoneal lymph node dissection (L-RPLND) and open retroperitoneal lymph node dissection (O-RPLND) for low-stage (stage I/II) testicular germ cell tumors.
METHODS: We performed a systematic review and cumulative meta-analysis of the primary outcomes of interest according to PRISMA criteria, and the quality assessment of the included studies followed the AMSTAR guidelines. Four databases were searched, including Embase, PubMed, Cochrane Library, and Web of Science. The search period was from the creation of each database to October 2022. The statistical analysis software uses Stata17.
RESULTS: There were nine studies involving 579 patients. Compared with O-RPLND, L-RPLND was associated with shorter length of stay (WMD=-3.99, 95% CI [-4.80, -3.19], P<0.05), less estimated blood loss (WMD=-0.95, 95% CI [-1.35, -0.54], P<0.05), shorter time to oral intake after surgery (WMD=-0.77, 95% CI [-1.50, -0.03], P<0.05), and lower overall complications (OR=0.58, 95% CI [0.38, 0.87], P<0.05). Subgroup analysis found that the complication rate of Clavien-Dindo grade II was lower in L-RPLND (OR=0.24, 95% CI [0.11, 0.55], P<0.05). Interestingly, there was no statistically significant difference between the two groups in terms of operation time, lymph node yields, and recurrence rate during follow-up.
CONCLUSION: Laparoscopic retroperitoneal lymph node dissection is superior to open retroperitoneal lymph node dissection and is worthy of clinical promotion.
PMID:36917132 | DOI:10.1097/JS9.0000000000000321