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梅奥黏附概率评分预测腹腔镜部分肾切除术时的手术时间更长。

The Mayo Adhesive Probability Score Predicts Longer Dissection Time During Laparoscopic Partial Nephrectomy.

机构信息

Department of Urology/State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital, Beijing, People's Republic of China.

出版信息

J Endourol. 2020 May;34(5):594-599. doi: 10.1089/end.2019.0687. Epub 2020 Apr 21.

Abstract

To examine the impact of the Mayo adhesive probability (MAP) score on the surgical complexity of exposing the tumor during laparoscopic partial nephrectomy (LPN). Our study included 318 patients who underwent LPN from January 2017 to December 2018 at our institution. Patients were divided into a lower MAP score group (≤2,  = 172) and a higher MAP score group (≥3,  = 146). Perioperative outcomes were compared between the groups. The operative time was predominantly occupied by the dissection time and the warm ischemia time (WIT). A higher MAP score was associated with a longer operative time (131 110 minutes,  < 0.001) and longer dissection time (71 54 minutes,  < 0.001), respectively. The estimated blood loss (EBL) increased in patients with a higher MAP score (50 20 mL,  < 0.001). No significant difference was found with respect to the WIT (21 20 minutes,  = 0.370). In the multivariate linear regression model, male gender (β = 11.199,  = 0.001), body mass index (β = 1.197,  = 0.008), and MAP score (β = 9.958,  = 0.002) were significantly associated with the prolongation of dissection time. The MAP score was significantly associated with the prolongation of dissection time during LPN. In addition, the EBL increased in patients with a higher MAP score. Therefore, the MAP score can predict surgical complexity of exposing the tumor in patients undergoing LPN.

摘要

为了探讨梅奥粘附概率(MAP)评分对腹腔镜部分肾切除术(LPN)中暴露肿瘤手术难度的影响。我们的研究纳入了 2017 年 1 月至 2018 年 12 月在我院行 LPN 的 318 例患者。患者分为 MAP 评分较低组(≤2,n=172)和 MAP 评分较高组(≥3,n=146)。比较两组患者围手术期结局。手术时间主要由解剖时间和热缺血时间(WIT)决定。MAP 评分较高与手术时间较长(131±110 分钟,<0.001)和解剖时间较长(71±54 分钟,<0.001)有关。MAP 评分较高的患者估计失血量(EBL)增加(50±20 毫升,<0.001)。但 WIT 无显著差异(21±20 分钟,=0.370)。多元线性回归模型显示,男性(β=11.199,=0.001)、体质指数(β=1.197,=0.008)和 MAP 评分(β=9.958,=0.002)与解剖时间延长显著相关。MAP 评分与 LPN 中暴露肿瘤的手术难度显著相关。此外,MAP 评分较高的患者 EBL 增加。因此,MAP 评分可以预测行 LPN 患者肿瘤暴露的手术难度。

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