1 Department of Urology, Tokyo Women's Medical University , Tokyo, Japan .
2 Department of Urology, Tokyo Women's Medical University Medical Center East , Tokyo, Japan .
J Endourol. 2018 Oct;32(10):928-933. doi: 10.1089/end.2017.0779. Epub 2018 Sep 25.
Mayo adhesive probability (MAP) score quantifies adherent perinephric fat (APF) and is associated with the prolongation of surgery duration or the increase of surgical complication rates.
In this study, 311 patients who underwent robot-assisted partial nephrectomy (RAPN) at our institute were included. APF was quantified using the MAP score calculated using perinephric fat thickness and stranding seen on a preoperative enhanced CT scans. The surgery duration was classified into the dissection (robotic manipulation to hilar clamping) and resection (hilar clamping to robotic surgery completion) phases.
The MAP score was found to be 0, 1, 2, 3, 4, and 5 in 98 (32%), 86 (28%), 21 (7%), 48 (15%), 44 (14%), and 14 (4%) patients, respectively. The dissection and resection phase times increased with an increase in the MAP score. The median dissection phase times for MAP scores of 0, 1, 2, 3, 4, and 5 were 71.7, 79.1, 88.9, 97.0, 99.7, and 118.8 minutes, respectively. The MAP score was more strongly associated with the prolongation of the dissection phase than with the prolongation of the resection phase. In multivariate analysis for dissection phase time of more than 90 minutes, the body mass index [odds ratio (OR) = 1.09, p = 0.0209], early surgical experience (first 100 cases) (OR = 2.32, p = 0.0024), and MAP score ≥3 (OR = 6.20, p < 0.0001) significantly associated with the prolongation of dissection phase in a logistic regression model.
The MAP score is a factor significantly associated with the prolongation of the dissection phase during RAPN.
梅奥黏附概率（MAP）评分量化了肾周黏附脂肪（APF），并与手术时间延长或手术并发症发生率增加相关。
本研究纳入了在我院行机器人辅助部分肾切除术（RAPN）的 311 例患者。使用术前增强 CT 扫描上测量的肾周脂肪厚度和条索状结构计算 MAP 评分来量化 APF。手术时间分为解剖（从肾门夹闭到机器人操作）和切除（从肾门夹闭到机器人手术完成）两个阶段。
98 例（32%）、86 例（28%）、21 例（7%）、48 例（15%）、44 例（14%）和 14 例（4%）患者的 MAP 评分分别为 0、1、2、3、4 和 5。MAP 评分增加，解剖和切除阶段时间增加。MAP 评分分别为 0、1、2、3、4 和 5 的患者，其解剖阶段的中位数时间分别为 71.7、79.1、88.9、97.0、99.7 和 118.8 分钟。MAP 评分与解剖阶段时间延长的相关性强于与切除阶段时间延长的相关性。在超过 90 分钟的解剖阶段时间的多变量分析中，体重指数（比值比（OR）=1.09，p=0.0209）、早期手术经验（前 100 例）（OR=2.32，p=0.0024）和 MAP 评分≥3（OR=6.20，p<0.0001）在逻辑回归模型中与解剖阶段时间延长显著相关。
MAP 评分是 RAPN 中解剖阶段延长的一个显著相关因素。
