Letter to the editor on “Ablation versus laparoscopic adrenalectomy for the treatment of aldosterone-producing adenoma: a meta-analysis”

Abstract

To the editor, Chen et al. [1] meta-analyzed the studies comparing radiofrequency ablation (RFA) with laparoscopic adrenalectomy (LA), which is currently held to be the gold standard for the surgical treatment of patients with primary aldosteronism (PA) due to unilateral aldosterone-producing adenoma (APA). They could include only five small non-randomized retrospective studies [2-6], and, moreover, their meta-analysis was affected by several methodological flaws and mistakes that, on the whole, question the validity of its results and the strength of its conclusions.First, prerequisites for including studies in a metaanalysis are a thorough check of their quality and exclusion of duplicated cases. The study by Chen et al.[1] fell short on both these items. They could not include any prospective randomized trial and the quality assessment score used by the Authors [7] revealed that all studies included are high quality, but the Newcastle-Ottawa score (NOS)