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Background: The effectiveness and safety of laparoscopic adrenalectomy (LA) under different routes for the treatment of large pheochromocytomas (PCCs) is unknown. Materials and methods: This meta-analysis and systematic review was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and AMSTAR (Assessing the methodological quality of systematic reviews) Guidelines. Three databases were systematically searched, including Medline, PubMed, and Web of Science. The time frame of the search was set from the creation of the database to October 2022. Perioperative outcomes were divided into two groups according to tumor size: SMALL group (≤6 cm in diameter), LARGE group (>6 cm in diameter). Results: Eight studies including 600 patients were included. In the LA group, complications was comparable in both groups (SMALL group and LARGE group), and the LARGE group had longer operative time [OT weighted mean difference (WMD)=32.55; 95% CI: 11.17, 53.92; P<0.01], length of stay (LOS WMD=0.82; 95% CI: 0.19, 1.44; P<0.05), more estimated blood loss (EBL WMD=85.26; 95% CI: 20.71, 149.82; P<0.05), hypertension [odds ratio (OR)=3.99; 95% CI: 1.84, 8.65; P<0.01], hypotension (OR=1.84; 95% CI: 1.11, 3.05; P<0.05), and conversion (OR=5.60; 95% CI: 1.56, 20.13; P<0.01). In the transabdominal LA group, OT, LOS, EBL, complications, hypertension, and hypotension were the same in both groups. In the retroperitoneal LA group, complications and hypotension were the same in both groups, while the LARGE group had longer OT (WMD=52.07; 95% CI: 26.95, 77.20; P<0.01), LOS (WMD=0.51; 95% CI: 0.00, 1.01; P<0.05), more EBL (WMD=92.99; 95% CI: 27.70, 158.28; P<0.01) and higher rates of hypertension (OR=6.03; 95% CI: 1.95, 18.61; P<0.01). Conclusions: LA remains a safe and effective approach for large PCC. Transabdominal LA is superior to retroperitoneal LA.

ObjectiveTo evaluate and compare the efficacy and safety between an external stent and a Double J stent for pediatric Pyeloplasty.MethodsThrough a systematical search of multiple scientific databases in July 2022, we performed a systematic review and meta-analysis of the primary outcomes of interest according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), whose protocol was registered with PROSPERO(CRD42021274087).ResultsEleven studies involving 1,758 patients were included. No significant differences were observed in operative time (MD: 2.26; 95% CI −9.62 to 14.14; P = 0.79), operative success rate (OR: 1.10; 95% CI 0.57 to 2.10; P = 0.780), length of hospital stay (MD: 0.65; 95% CI −0.04 to 1.34; P = 0.063), or complications (OR: 0.87; 95%CI 0.48 to 1.56; P = 0.630) between external stents and DJ stents in pediatric pyeloplasty. According to the subgroup analysis, we found the external stent group had a shorter operative time than the DJ stent group in terms of robot-assisted laparoscopic pyeloplasty (MD: −17.13; 95% CI −32.8 to −1.45; P = 0.032).ConclusionsThere were no significant differences in operative time, operative success rate, length of hospital stay, or complications between external stents and DJ stents in pediatric pyeloplasty. The external stented procedure seemed to have less operative time when using robot-assisted laparoscopic pyeloplasty. However, due to the limitations of our analysis, more studies are still required to support our conclusion.Systematic review registrationThis systematic review has been registered on PROSPERO, the registration ID is CRD42021274087.

Background To compare the safety and clinical efficacy of Moses laser enucleation of the prostate (MoLEP) with those of holmium laser enucleation of the prostate (HoLEP) for treating benign prostatic hyperplasia (BPH). Methods We systematically searched PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang databases, and SinoMed databases. The retrieval period was from the establishment of the database to March 2022. Stata17.0 was used for calculations and statistical analyses. Results This study included 12 articles comprising 1160 patients for meta‐analysis. Compared with those of the HoLEP group, the hemostasis time (weighted mean difference [WMD] = −4.66, 95% confidence interval [CI] [−6.47, −2.84], p < 0.001), enucleation time (WMD = −7.23, 95% CI [−10.67, −3.79], p < 0.001), operative time (WMD = −15.02, 95% CI [−20.50, −9.53], p< 0.001), length of hospital stay (WMD = −15.02, 95% CI [−20.50, −9.53], p< 0.001), intraoperative blood loss (WMD = −11.19, 95% CI [−12.94, −9.44], p< 0.001), and total postoperative complications rate (OR = 0.51, 95% CI [0.32, 0.81], p = 0.004) were shorter in the MoLEP group. Postoperative quality of life (WMD = 0.30, 95% CI [0.00, 0.59], p = 0.047) was lower in the HoLEP group, and there were no statistically significant differences in the International Prostate Symptom Score, postoperative maximum urinary flow rate, and postoperative residual urine (p > 0.05). Conclusion MoLEP has more advantages than HoLEP in terms of safety, shorter operation time and hospital stay, and fewer complications. However, this conclusion needs to be verified with a larger sample size, longer follow‐up time, and multicenter randomized controlled trial data.

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