Laparoscopic Adrenalectomy Versus Percutaneous Ablation for Aldosterone‑Producing Adenoma: a Meta-analysis.

Aldosterone-producing adenoma (APA) is a relatively common form of benign adrenal tumor that can cause symptoms including hypertension, hypokalemia, and metabolic alkalosis. We aim to examine the safety and efficacy of laparoscopic adrenalectomy (LA) and percutaneous ablation (PA) as treatments for APA. The Embase, PubMed, Cochrane Library, Wanfang, VIP, and CINK databases were explored for related investigations, after which a meta-analysis was conducted with RevMan v5.3. In total, 4 studies including 102 and 79 APA patients treated via LA and PA, respectively, were included in this analysis, with all of these studies being retrospective in design. Pooled immediate treatment success rates, changes in serum potassium, rates of major complications, rates of minor complications, and rates of hypertensive crisis were similar in LA and PA treatment groups (P = 0.32, 0.24, 0.63, 0.69, and 0.09, respectively). Pooled operative and postoperative hospitalization durations were remarkably lower in PA-treated patients (P < 0.00001 and P = 0.004, respectively). With respect to long-term outcomes, pooled normal blood pressure rates were remarkably higher in the LA group compared with the PA group (P = 0.004), while there were no considerable discrepancies in pooled medication reduction or no response rates between groups (P = 0.20 and 0.56, respectively). Funnel plots did not reveal any evidence of potential publication bias. While PA treatment of patients with APA was related to shorter operative duration and length of postoperative hospitalization, LA treatment of these patients was associated with better long-term patient outcomes. [ABSTRACT FROM AUTHOR]