Body mass index and outcomes of patients with laparoscopic adrenalectomy: A systematic review and meta-analysis protocol

Introduction Recent advances in the field of medical imaging and minimal invasive surgery have improved the diagnosis and treatment of adrenal incidentalomas. Recent studies suggest increased morbidity and mortality among patients with obesity following laparoscopic adrenalectomy compared with patients without obesity. However, this claim remains to be ascertained. This review seeks to assess the outcome of patients with and without obesity after adrenalectomy. Methods and design We will include cohort studies, case-control studies, cross-sectional studies and case series with more than 30 participants. EMBASE, Medline and Web of Science (Web of Science Core Collection, Current Contents Connect, KCI-Korean Journal Database, SciELO Citation Index, Russian Science Citation Index) will be searched for relevant abstracts of studies published between 1 January 2000 and 31 May 2019, without language restriction. The review will be reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. After screening of abstracts, study selection, data extraction and methodological quality assessment, we shall assess the studies individually for clinical and statistical heterogeneity. Random-effect meta-analysis will be used to pool studies judged to be clinically homogenous. The Harbord's test and visual inspection of funnel plots will be used to assess publication bias. Results will be presented by country and region. Ethics and dissemination Since primary data are not collected in this study, ethical approval is not required. This review is expected to provide relevant data on the impact of body mass index on the outcome of laparoscopic adrenalectomy. The final report will be published in a peer-reviewed journal. PROSPERO registration number CRD42018117070. Review status Preliminary searches.