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总上腺切除术与双边花红细胞瘤的亚总上腺切除术:元分析
Donatella Schiavone1,2, Mattia Ballo3, Marco Filardo3
1Department of Medicine-DIMED, University of Padua, Padua, Italy.
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|November 9, 2023
概括
亚总 adrenalectomy 减少了类固醇依赖,但增加了双边 pheochromocytoma 的复发风险. 需要进一步的研究来证实这些关于上腺切除术结果的发现.
科学领域:
- 内分泌学 在内分泌学.
- 手术瘤学手术瘤学
背景情况:
- 双边染细胞瘤是罕见的,通常是遗传性瘤.
- 总上腺切除术可以提供瘤治疗,但会导致永久性低皮质醇症.
- 亚总上腺切除术是一种替代性手术方法.
研究的目的:
- 为了比较双边染细胞瘤的总上腺切除与次总上腺切除.
- 评估术后复发,转移性疾病和类固醇依赖.
主要方法:
- 从1945年到2023年6月进行系统的文献搜索 (PubMed,Embase,欧洲PMC).
- 按照PRISMA指南进行的10项回顾性研究 (1202名患者) 的元分析.
- 使用纽卡斯尔-太华和ROBINS-I工具进行质量和偏见评估.
主要成果:
- 亚总上腺切除术的复发率为14.1%,而总上腺切除术的复发率为2.6%.
- 总上腺切除术后的类固醇依赖率为93.3%,次总上腺切除术后为11.6%.
- 两种方法之间在术后转移性疾病中没有显著差异.
结论:
- 亚总上腺切除术导致上腺功能衰竭较少,但复发率更高.
- 需要前性随机试验来验证这些发现.
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