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Systematic Review

Impact of Obesity on Short-Term Outcomes in Patients Undergoing Retroperitoneal Laparoscopic/Retroperitoneoscopic Adrenalectomy for Benign or Malignant Adrenal Diseases: A Meta-Analysis

by
Maurizio Zizzo
1,*,
Andrea Morini
1,
Magda Zanelli
2,
Chiara Grasselli
3,
Francesca Sanguedolce
4,
Sze Ling Wong
5,6,
Munyaradzi G. Nyandoro
5,7,
Andrea Palicelli
2,
Giuseppe Broggi
8,
Nektarios I. Koufopoulos
9,
Lucia Mangone
10,
Angelo Cormio
11,
Rosario Caltabiano
8,
Antonino Neri
12 and
Massimiliano Fabozzi
1
1
Surgical Oncology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
2
Pathology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
3
Cardiovascular Medicine Unit and Secondary Hypertension Center, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
4
Pathology Unit, Azienda Ospedaliero-Universitaria, Ospedali Riuniti di Foggia, 71122 Foggia, Italy
5
General and Endocrine Surgery, Royal Perth Hospital, Perth, WA 6000, Australia
6
General and Endocrine Surgery, St. John of God Murdoch Hospital, Murdoch, WA 6150, Australia
7
General and Endocrine Surgery, Fiona Stanley Hospital, Murdoch, WA 6150, Australia
8
Department of Medical and Surgical Sciences and Advanced Technologies “G.F. Ingrassia”, Anatomic Pathology, University of Catania, 95123 Catania, Italy
9
Second Department of Pathology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, 15772 Athens, Greece
10
Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
11
Urology Unit, Azienda Ospedaliero-Universitaria Ospedali Riuniti di Ancona, Università Politecnica Delle Marche, 60126 Ancona, Italy
12
Scientific Directorate, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
 
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*
Author to whom correspondence should be addressed.
Medicina 2025, 61(1), 106; https://doi.org/10.3390/medicina61010106
Submission received: 20 September 2024 / Revised: 15 November 2024 / Accepted: 7 January 2025 / Published: 13 January 2025
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Abstract

Background and Objectives: Retroperitoneal laparoscopic adrenalectomy (RLA) is one of two laparoscopic procedures used to treat benign and malignant adrenal diseases. Obesity in patients undergoing minimally invasive adrenal surgery is a frequently discussed topic. Our meta-analysis aimed to provide updated evidence by comparing intraoperative and perioperative outcomes on non-obese (NOb) and obese (Ob) patients who underwent RLA due to benign or malignant disease. Materials and Methods: We performed a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. PubMed/MEDLINE, Scopus, Web of Science (Science and Social Science Citation Index), and Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL)) databases were used to identify articles of interest. The meta-analysis was performed using RevMan [Computer program] Version 5.4. Results: The four included comparative studies (809 patients: 552 NOb versus 257 Ob) covered an approximately 15-year-study period (2007–2022). All the included studies were observational in nature. By comparing the Ob and NOb groups, shorter operative time and lower overall postoperative complication rates in the NOb population were recorded through the meta-analysis. Considering the subgroup analysis (BMI ≥ 30 kg/m2), just the operative time maintained statistical significance. Conclusions: Obesity did not appear to impact RLA safety and effectiveness. Due to important biases (small overall sample size and few analyzed events), the interpretation of our results must be a careful one. Later randomized and multi-center trials may help the confirmation of our results.
Keywords: adrenal gland; adrenalectomy; laparoscopy; surgery; obesity; body mass index; outcomes adrenal gland; adrenalectomy; laparoscopy; surgery; obesity; body mass index; outcomes

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MDPI and ACS Style

Zizzo, M.; Morini, A.; Zanelli, M.; Grasselli, C.; Sanguedolce, F.; Wong, S.L.; Nyandoro, M.G.; Palicelli, A.; Broggi, G.; Koufopoulos, N.I.; et al. Impact of Obesity on Short-Term Outcomes in Patients Undergoing Retroperitoneal Laparoscopic/Retroperitoneoscopic Adrenalectomy for Benign or Malignant Adrenal Diseases: A Meta-Analysis. Medicina 2025, 61, 106. https://doi.org/10.3390/medicina61010106

AMA Style

Zizzo M, Morini A, Zanelli M, Grasselli C, Sanguedolce F, Wong SL, Nyandoro MG, Palicelli A, Broggi G, Koufopoulos NI, et al. Impact of Obesity on Short-Term Outcomes in Patients Undergoing Retroperitoneal Laparoscopic/Retroperitoneoscopic Adrenalectomy for Benign or Malignant Adrenal Diseases: A Meta-Analysis. Medicina. 2025; 61(1):106. https://doi.org/10.3390/medicina61010106

Chicago/Turabian Style

Zizzo, Maurizio, Andrea Morini, Magda Zanelli, Chiara Grasselli, Francesca Sanguedolce, Sze Ling Wong, Munyaradzi G. Nyandoro, Andrea Palicelli, Giuseppe Broggi, Nektarios I. Koufopoulos, and et al. 2025. "Impact of Obesity on Short-Term Outcomes in Patients Undergoing Retroperitoneal Laparoscopic/Retroperitoneoscopic Adrenalectomy for Benign or Malignant Adrenal Diseases: A Meta-Analysis" Medicina 61, no. 1: 106. https://doi.org/10.3390/medicina61010106

APA Style

Zizzo, M., Morini, A., Zanelli, M., Grasselli, C., Sanguedolce, F., Wong, S. L., Nyandoro, M. G., Palicelli, A., Broggi, G., Koufopoulos, N. I., Mangone, L., Cormio, A., Caltabiano, R., Neri, A., & Fabozzi, M. (2025). Impact of Obesity on Short-Term Outcomes in Patients Undergoing Retroperitoneal Laparoscopic/Retroperitoneoscopic Adrenalectomy for Benign or Malignant Adrenal Diseases: A Meta-Analysis. Medicina, 61(1), 106. https://doi.org/10.3390/medicina61010106

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