Comparison between laparoscopic partial nephrectomy and laparoscopic ablation therapy: a meta-analysis

Minim Invasive Ther Allied Technol. 2014 Dec;23(6):317-25. doi: 10.3109/13645706.2014.925930. Epub 2014 Sep 2.

Abstract

Objective: To conduct a meta-analysis of the literature evaluating comparisons on the peri-operative and oncological outcomes between laparoscopic partial nephrectomy (LPN) and laparoscopic ablation therapy (LAT) in the treatment of small renal masses (SRMs).

Material and methods: MEDLINE, EMBASE, Google Scholar, Cochrane Library, and CNKI were searched for clinical trials comparing LPN with LAT. Data of peri-operative and follow-up outcomes were extracted and compared. Publication bias was identified and sensitivity analysis was also performed.

Results: Data from 11 studies including 928 patients (525 patients in the LPN group and 403 in the LAT group) were collected. Baseline characteristics were compared and differences were found in age, preoperative renal function and proportion of solitary kidney (p < 0.05 respectively). For peri-operative outcomes, the LPN group had greater estimated blood loss, longer operative duration and length of hospital stay, and more peri-operative complications (p < 0.05, respectively). The LAT group had a significantly higher local recurrence (p < 0.05). There was no significant difference in postoperative change of renal function (p = 0.21).

Conclusion: In comparison with LPN, LAT provides better peri-operative outcomes, but a higher local recurrence rate. LAT does not seem to provide an obvious advantage in protecting renal function. Further clinical trials with randomized design and long-term follow-up are needed.

Keywords: Laparoscopic; ablation therapy; partial nephrectomy; small renal masses.

Publication types

  • Comparative Study
  • Meta-Analysis

MeSH terms

  • Ablation Techniques / methods*
  • Clinical Trials as Topic
  • Humans
  • Kidney Neoplasms / surgery*
  • Laparoscopy / adverse effects
  • Laparoscopy / methods*
  • Length of Stay / statistics & numerical data
  • Neoplasm Recurrence, Local
  • Nephrectomy / adverse effects
  • Nephrectomy / methods*
  • Perioperative Period / statistics & numerical data
  • Postoperative Complications / epidemiology