Efficacy and Safety of Laparoscopic Nephrectomy versus Open Nephrectomy for Autosomal Dominant Polycystic Kidney Disease: A Meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

 ZHOUChen-chen ¹ , YANGMing ¹ , WANGWu-tao ¹ , GUXiang-chen ¹ , YANGBo ¹ , YILu-jiang ² , LIUZhi-jia ³ , FUDian ⁴ , YUFei ⁴ ,  XUECheng ¹

1. Department of Nephrology, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, China;
2. Clinical Laboratory, People's Hospital of Jiangsu Province, Nanjing 210029, China;
3. Department of Kidney transplantation, 309 Hospital of PLA, Beijing 100000, China;
4. Department of Urology, General Hospital of Nanjing Military Region, Nanjing 210000, China;

Corresponding author：

XUECheng, Email: chengxia1568@126.com

Keywords：

Autosomal dominant polycystic kidney disease; Nephrectomy; Meta-analysis; Systematic review; Cohort study

DOI：

10.7507/1672-2531.20150156

Video：

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Objective To systematically review the efficacy and safety of laparoscopic versus open nephrectomy in the treatment of autosomal dominant polycystic kidney disease (ADPKD). Methods We searched databases including MEDLINE, EMbase, The Cochrane Library (Issue 1, 2015), Web of Science, CBM and WanFang Data to collect relevant clinical studies comparing the efficacy and safety of laparoscopic versus open nephrectomy for ADPKD from inception to Jan, 2015. Two reviewers independently screened literature, extracted data and assessed the risk bias of included studies. Then, RevMan 5.4 software was used for meta-analysis. Results A total of six retrospective cohort studies involving 182 patients were included. The results of the meta-analysis showed that:compared with the open nephrectomy group, the average hospitalization time was shorter (MD=-4.38 days, 95%CI -5.93 to -2.83, P=0.000 01) and the blood transfusion risk was lower (OR=0.25, 95%CI 0.10 to 0.62, P=0.003) in the laparoscopic nephrectomy group. However, there was no significant difference between two groups in the incidence of overall complications (OR=0.51, 95%CI 0.24 to 1.06, P=0.07). Conclusion The application of laparoscopic nephrectomy for ADPKD can reduce the hospitalization time and blood transfusion risk when compared with the open nephrectomy, but the two operations have similar overall complication rate. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.

Citation： ZHOUChen-chen, YANGMing, WANGWu-tao, GUXiang-chen, YANGBo, YILu-jiang, LIUZhi-jia, FUDian, YUFei, XUECheng. Efficacy and Safety of Laparoscopic Nephrectomy versus Open Nephrectomy for Autosomal Dominant Polycystic Kidney Disease: A Meta-analysis. Chinese Journal of Evidence-Based Medicine, 2015, 15(8): 930-937. doi: 10.7507/1672-2531.20150156 Copy

1.	Verhoest G, Delreux A, Mathieu R, et al. Transperitoneal laparoscopic nephrectomy for autosomal dominant polycystic kidney disease. JSLS, 2012, 16(3):437-442.
2.	Seshadri PA, Poulin EC, Pace D, et al. Transperitoneal laparoscopic nephrectomy for giant polycystic kidneys:a case control study. Urology, 2001, 58(1):23-27.
3.	Menezes LF, Zhou F, Patterson AD, et al. Network analysis of a Pkd1-mouse model of autosomal dominant polycystic kidney disease identifies HNF4alpha as a disease modifier. PLoS Genet, 2012, 8(11):e1003053.
4.	Chang MY, Ong AC. Mechanism-based therapeutics for autosomal dominant polycystic kidney disease:recent progress and future prospects. Nephron Clin Pract, 2012, 120(1):c25-34; discussion c35.
5.	Dunn MD, Portis AJ, Elbahnasy AM, et al. Laparoscopic nephrectomy in patients with end-stage renal disease and autosomal dominant polycystic kidney disease. Am J Kidney Dis, 2000, 35(4):720-725.
6.	Xue C, Nie W, Xu J, et al. C509T and T869C polymorphisms of transforming growth factor beta1 and the risk of IgA nephropathy:a meta-analysis. Chin Med J (Engl), 2013, 126(23):4562-4567.
7.	Egger M, Davey SG, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test. BMJ, 1997, 315(7109):629-634.
8.	Gill IS, Kaouk JH, Hobart MG, et al. Laparoscopic bilateral synchronous nephrectomy for autosomal dominant polycystic kidney disease:the initial experience. J Urol, 2001, 165(4):1093-1098.
9.	Patel P, Horsfield C, Compton F, et al. Native nephrectomy in transplant patients with autosomal dominant polycystic kidney disease. Ann R Coll Surg Engl, 2011, 93(5):391-395.
10.	Eng M, Jones CM, Cannon RM, et al. Hand-assisted laparoscopic nephrectomy for polycystic kidney disease. JSLS, 2013, 17(2):279-284.
11.	Desai MR, Nandkishore SK, Ganpule A, et al. Pretransplant laparoscopic nephrectomy in adult polycystic kidney disease:a single centre experience. BJU Int, 2008, 101(1):94-97.
12.	Sathiyakumar V, Molina CS, Thakore RV, et al. ASA Score as a Predictor of 30-Day Perioperative Readmission in Patients With Orthopaedic Trauma Injuries:An NSQIP Analysis. J Orthop Trauma, 2015, 29(3):e127-132.
13.	Torres VE, Harris PC, Pirson Y. Autosomal dominant polycystic kidney disease. Lancet, 2007, 369(9569):1287-1301.
14.	Bennett AH, Stewart W, Lazarus JM. Bilateral nephrectomy in patients with polycystic renal disease. Surg Gynecol Obstet, 1973, 137(5):819-820.
15.	Takakura A, Nelson EA, Haque N, et al. Pyrimethamine inhibits adult polycystic kidney disease by modulating STAT signaling pathways. Hum Mol Genet, 2011, 20(21):4143-4154.
16.	Bansal RK, Kapoor A. Laparoscopic nephrectomy for massive polycystic kidney disease:Updated technique and outcomes. Can Urol Assoc J, 2014, 8(9-10):341-345.
17.	Serra AL, Kistler AD, Poster D, et al. Safety and tolerability of sirolimus treatment in patients with autosomal dominant polycystic kidney disease, in Nephrology, dialysis, transplantation:official publication of the European Dialysis and Transplant Association-European Renal Association, 2009, pp. 3334-3342.
18.	Wisenbaugh ES, Tyson MD 2nd, Castle EP, et al. Massive renal size is not a contraindication to a laparoscopic approach for bilateral native nephrectomies in autosomal dominant polycystic kidney disease (ADPKD). BJU Int, 2014, 115(5):796-801.
19.	Tellman MW, Bahler CD, Shumate AM, et al. Management of pain in autosomal dominant polycystic kidney disease and anatomy of renal innervation. J Urol, 2015, 193(5):1470-1478.
20.	Xue C, Dai B, Mei C. Long-term treatment with mammalian target of rapamycin inhibitor does not benefit patients with autosomal dominant polycystic kidney disease:a meta-analysis. Nephron Clin Pract, 2013, 124(1-2):10-16.

1. Verhoest G, Delreux A, Mathieu R, et al. Transperitoneal laparoscopic nephrectomy for autosomal dominant polycystic kidney disease. JSLS, 2012, 16(3):437-442.
2. Seshadri PA, Poulin EC, Pace D, et al. Transperitoneal laparoscopic nephrectomy for giant polycystic kidneys:a case control study. Urology, 2001, 58(1):23-27.
3. Menezes LF, Zhou F, Patterson AD, et al. Network analysis of a Pkd1-mouse model of autosomal dominant polycystic kidney disease identifies HNF4alpha as a disease modifier. PLoS Genet, 2012, 8(11):e1003053.
4. Chang MY, Ong AC. Mechanism-based therapeutics for autosomal dominant polycystic kidney disease:recent progress and future prospects. Nephron Clin Pract, 2012, 120(1):c25-34; discussion c35.
5. Dunn MD, Portis AJ, Elbahnasy AM, et al. Laparoscopic nephrectomy in patients with end-stage renal disease and autosomal dominant polycystic kidney disease. Am J Kidney Dis, 2000, 35(4):720-725.
6. Xue C, Nie W, Xu J, et al. C509T and T869C polymorphisms of transforming growth factor beta1 and the risk of IgA nephropathy:a meta-analysis. Chin Med J (Engl), 2013, 126(23):4562-4567.
7. Egger M, Davey SG, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test. BMJ, 1997, 315(7109):629-634.
8. Gill IS, Kaouk JH, Hobart MG, et al. Laparoscopic bilateral synchronous nephrectomy for autosomal dominant polycystic kidney disease:the initial experience. J Urol, 2001, 165(4):1093-1098.
9. Patel P, Horsfield C, Compton F, et al. Native nephrectomy in transplant patients with autosomal dominant polycystic kidney disease. Ann R Coll Surg Engl, 2011, 93(5):391-395.
10. Eng M, Jones CM, Cannon RM, et al. Hand-assisted laparoscopic nephrectomy for polycystic kidney disease. JSLS, 2013, 17(2):279-284.
11. Desai MR, Nandkishore SK, Ganpule A, et al. Pretransplant laparoscopic nephrectomy in adult polycystic kidney disease:a single centre experience. BJU Int, 2008, 101(1):94-97.
12. Sathiyakumar V, Molina CS, Thakore RV, et al. ASA Score as a Predictor of 30-Day Perioperative Readmission in Patients With Orthopaedic Trauma Injuries:An NSQIP Analysis. J Orthop Trauma, 2015, 29(3):e127-132.
13. Torres VE, Harris PC, Pirson Y. Autosomal dominant polycystic kidney disease. Lancet, 2007, 369(9569):1287-1301.
14. Bennett AH, Stewart W, Lazarus JM. Bilateral nephrectomy in patients with polycystic renal disease. Surg Gynecol Obstet, 1973, 137(5):819-820.
15. Takakura A, Nelson EA, Haque N, et al. Pyrimethamine inhibits adult polycystic kidney disease by modulating STAT signaling pathways. Hum Mol Genet, 2011, 20(21):4143-4154.
16. Bansal RK, Kapoor A. Laparoscopic nephrectomy for massive polycystic kidney disease:Updated technique and outcomes. Can Urol Assoc J, 2014, 8(9-10):341-345.
17. Serra AL, Kistler AD, Poster D, et al. Safety and tolerability of sirolimus treatment in patients with autosomal dominant polycystic kidney disease, in Nephrology, dialysis, transplantation:official publication of the European Dialysis and Transplant Association-European Renal Association, 2009, pp. 3334-3342.
18. Wisenbaugh ES, Tyson MD 2nd, Castle EP, et al. Massive renal size is not a contraindication to a laparoscopic approach for bilateral native nephrectomies in autosomal dominant polycystic kidney disease (ADPKD). BJU Int, 2014, 115(5):796-801.
19. Tellman MW, Bahler CD, Shumate AM, et al. Management of pain in autosomal dominant polycystic kidney disease and anatomy of renal innervation. J Urol, 2015, 193(5):1470-1478.
20. Xue C, Dai B, Mei C. Long-term treatment with mammalian target of rapamycin inhibitor does not benefit patients with autosomal dominant polycystic kidney disease:a meta-analysis. Nephron Clin Pract, 2013, 124(1-2):10-16.

Chinese Journal of Evidence-Based Medicine

Efficacy and Safety of Laparoscopic Nephrectomy versus Open Nephrectomy for Autosomal Dominant Polycystic Kidney Disease: A Meta-analysis

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