Laparoscopic vs Percutaneous Cryotherapy for Renal Tumors: A Systematic Review and Meta-Analysis
Cryoablation has emerged as an alternative to the more invasive partial nephrectomy for small renal masses. The approach can be carried out by two techniques, either laparoscopic cryoablation (LCA) or percutaneous cryoablation, (PCA) with CT guidance. We aimed to compare between the two procedures....
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| Veröffentlicht in: | Journal of endourology 2018-03, Vol.32 (3), p.177-183 |
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| container_title | Journal of endourology |
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| creator | Aboumarzouk, Omar M Ismail, Mohamed Breen, David J Van Strijen, Marco Garnon, Julien Lagerveld, Brunolf Nielsen, Tommy Kjærgaard Keeley, Jr, Francis Xavier |
| description | Cryoablation has emerged as an alternative to the more invasive partial nephrectomy for small renal masses. The approach can be carried out by two techniques, either laparoscopic cryoablation (LCA) or percutaneous cryoablation, (PCA) with CT guidance. We aimed to compare between the two procedures.
A systematic review and meta-analysis was conducted, including studies comparing the two techniques. Outcomes included incomplete ablation, late local recurrence, cancer-specific survival, procedure time, transfusion rates, hospital stay, and complications.
A total of 1475 patients were included, 788 patients in the laparoscopic group and 687 patients in the percutaneous group. There was statistical difference favoring the laparoscopic group with regard to having less incomplete ablation (p = 0.0008) and higher cancer-specific survival patients (p = 0.04). However, there was longer hospital stays in the LCA group (p |
| doi_str_mv | 10.1089/end.2017.0791 |
| format | Article |
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A systematic review and meta-analysis was conducted, including studies comparing the two techniques. Outcomes included incomplete ablation, late local recurrence, cancer-specific survival, procedure time, transfusion rates, hospital stay, and complications.
A total of 1475 patients were included, 788 patients in the laparoscopic group and 687 patients in the percutaneous group. There was statistical difference favoring the laparoscopic group with regard to having less incomplete ablation (p = 0.0008) and higher cancer-specific survival patients (p = 0.04). However, there was longer hospital stays in the LCA group (p < 0.00001) and was found to be more costly than the PCA group. There was significantly more Clavien-I complications in the PCA group (p = 0.001) and more Clavien-III complications in the LCA group (p = 0.001). Otherwise, there were no differences in any other outcome parameter.
LCA was found to have less incomplete tumor ablation rates and higher cancer-specific survival rates, however, higher hospitalization time, more major complications (Clavien III), and was costlier compared with PCA.</description><identifier>ISSN: 0892-7790</identifier><identifier>EISSN: 1557-900X</identifier><identifier>DOI: 10.1089/end.2017.0791</identifier><identifier>PMID: 29212363</identifier><language>eng</language><publisher>United States</publisher><subject>Aged ; Aged, 80 and over ; Cryotherapy - methods ; Female ; Humans ; Kidney Neoplasms - surgery ; Laparoscopy - methods ; Length of Stay - statistics & numerical data ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Nephrectomy - methods ; Operative Time ; Survival Rate</subject><ispartof>Journal of endourology, 2018-03, Vol.32 (3), p.177-183</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c332t-6031ebbc737f6dc630037062212191488df991883b302ee7966eca3d2f8f462b3</citedby><cites>FETCH-LOGICAL-c332t-6031ebbc737f6dc630037062212191488df991883b302ee7966eca3d2f8f462b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29212363$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Aboumarzouk, Omar M</creatorcontrib><creatorcontrib>Ismail, Mohamed</creatorcontrib><creatorcontrib>Breen, David J</creatorcontrib><creatorcontrib>Van Strijen, Marco</creatorcontrib><creatorcontrib>Garnon, Julien</creatorcontrib><creatorcontrib>Lagerveld, Brunolf</creatorcontrib><creatorcontrib>Nielsen, Tommy Kjærgaard</creatorcontrib><creatorcontrib>Keeley, Jr, Francis Xavier</creatorcontrib><title>Laparoscopic vs Percutaneous Cryotherapy for Renal Tumors: A Systematic Review and Meta-Analysis</title><title>Journal of endourology</title><addtitle>J Endourol</addtitle><description>Cryoablation has emerged as an alternative to the more invasive partial nephrectomy for small renal masses. The approach can be carried out by two techniques, either laparoscopic cryoablation (LCA) or percutaneous cryoablation, (PCA) with CT guidance. We aimed to compare between the two procedures.
A systematic review and meta-analysis was conducted, including studies comparing the two techniques. Outcomes included incomplete ablation, late local recurrence, cancer-specific survival, procedure time, transfusion rates, hospital stay, and complications.
A total of 1475 patients were included, 788 patients in the laparoscopic group and 687 patients in the percutaneous group. There was statistical difference favoring the laparoscopic group with regard to having less incomplete ablation (p = 0.0008) and higher cancer-specific survival patients (p = 0.04). However, there was longer hospital stays in the LCA group (p < 0.00001) and was found to be more costly than the PCA group. There was significantly more Clavien-I complications in the PCA group (p = 0.001) and more Clavien-III complications in the LCA group (p = 0.001). Otherwise, there were no differences in any other outcome parameter.
LCA was found to have less incomplete tumor ablation rates and higher cancer-specific survival rates, however, higher hospitalization time, more major complications (Clavien III), and was costlier compared with PCA.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cryotherapy - methods</subject><subject>Female</subject><subject>Humans</subject><subject>Kidney Neoplasms - surgery</subject><subject>Laparoscopy - methods</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local</subject><subject>Nephrectomy - methods</subject><subject>Operative Time</subject><subject>Survival Rate</subject><issn>0892-7790</issn><issn>1557-900X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kMtOwzAQRS0EouWxZIu8ZJMytls7ZldVvKQiUCkSu-A4ExGUF3ZSlL_HVQurWcyZq7mHkAsGEwaxvsY6m3BgagJKswMyZrOZijTA-yEZhz2PlNIwIifefwEwIZk4JiOuOeNCijH5WJrWuMbbpi0s3Xj6gs72namx6T1duKHpPtGZdqB54-gKa1PSdV81zt_QOX0dfIeV6cLpCjcF_lBTZ_QJOxPNAzn4wp-Ro9yUHs_385S83d2uFw_R8vn-cTFfRlYI3kUSBMM0tUqoXGZWCgChQPLwJ9NsGsdZrjWLY5EK4IhKS4nWiIzncT6VPBWn5GqX27rmu0ffJVXhLZblrkrCtJqG_nwGAY12qA3FvcM8aV1RGTckDJKt1CRITbZSk63UwF_uo_u0wuyf_rMofgG8LHI2</recordid><startdate>201803</startdate><enddate>201803</enddate><creator>Aboumarzouk, Omar M</creator><creator>Ismail, Mohamed</creator><creator>Breen, David J</creator><creator>Van Strijen, Marco</creator><creator>Garnon, Julien</creator><creator>Lagerveld, Brunolf</creator><creator>Nielsen, Tommy Kjærgaard</creator><creator>Keeley, Jr, Francis Xavier</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201803</creationdate><title>Laparoscopic vs Percutaneous Cryotherapy for Renal Tumors: A Systematic Review and Meta-Analysis</title><author>Aboumarzouk, Omar M ; Ismail, Mohamed ; Breen, David J ; Van Strijen, Marco ; Garnon, Julien ; Lagerveld, Brunolf ; Nielsen, Tommy Kjærgaard ; Keeley, Jr, Francis Xavier</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c332t-6031ebbc737f6dc630037062212191488df991883b302ee7966eca3d2f8f462b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cryotherapy - methods</topic><topic>Female</topic><topic>Humans</topic><topic>Kidney Neoplasms - surgery</topic><topic>Laparoscopy - methods</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local</topic><topic>Nephrectomy - methods</topic><topic>Operative Time</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Aboumarzouk, Omar M</creatorcontrib><creatorcontrib>Ismail, Mohamed</creatorcontrib><creatorcontrib>Breen, David J</creatorcontrib><creatorcontrib>Van Strijen, Marco</creatorcontrib><creatorcontrib>Garnon, Julien</creatorcontrib><creatorcontrib>Lagerveld, Brunolf</creatorcontrib><creatorcontrib>Nielsen, Tommy Kjærgaard</creatorcontrib><creatorcontrib>Keeley, Jr, Francis Xavier</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of endourology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Aboumarzouk, Omar M</au><au>Ismail, Mohamed</au><au>Breen, David J</au><au>Van Strijen, Marco</au><au>Garnon, Julien</au><au>Lagerveld, Brunolf</au><au>Nielsen, Tommy Kjærgaard</au><au>Keeley, Jr, Francis Xavier</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Laparoscopic vs Percutaneous Cryotherapy for Renal Tumors: A Systematic Review and Meta-Analysis</atitle><jtitle>Journal of endourology</jtitle><addtitle>J Endourol</addtitle><date>2018-03</date><risdate>2018</risdate><volume>32</volume><issue>3</issue><spage>177</spage><epage>183</epage><pages>177-183</pages><issn>0892-7790</issn><eissn>1557-900X</eissn><abstract>Cryoablation has emerged as an alternative to the more invasive partial nephrectomy for small renal masses. The approach can be carried out by two techniques, either laparoscopic cryoablation (LCA) or percutaneous cryoablation, (PCA) with CT guidance. We aimed to compare between the two procedures.
A systematic review and meta-analysis was conducted, including studies comparing the two techniques. Outcomes included incomplete ablation, late local recurrence, cancer-specific survival, procedure time, transfusion rates, hospital stay, and complications.
A total of 1475 patients were included, 788 patients in the laparoscopic group and 687 patients in the percutaneous group. There was statistical difference favoring the laparoscopic group with regard to having less incomplete ablation (p = 0.0008) and higher cancer-specific survival patients (p = 0.04). However, there was longer hospital stays in the LCA group (p < 0.00001) and was found to be more costly than the PCA group. There was significantly more Clavien-I complications in the PCA group (p = 0.001) and more Clavien-III complications in the LCA group (p = 0.001). Otherwise, there were no differences in any other outcome parameter.
LCA was found to have less incomplete tumor ablation rates and higher cancer-specific survival rates, however, higher hospitalization time, more major complications (Clavien III), and was costlier compared with PCA.</abstract><cop>United States</cop><pmid>29212363</pmid><doi>10.1089/end.2017.0791</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged, 80 and over Cryotherapy - methods Female Humans Kidney Neoplasms - surgery Laparoscopy - methods Length of Stay - statistics & numerical data Male Middle Aged Neoplasm Recurrence, Local Nephrectomy - methods Operative Time Survival Rate |
| title | Laparoscopic vs Percutaneous Cryotherapy for Renal Tumors: A Systematic Review and Meta-Analysis |
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