Department of Urology, Shenzhen People's Hospital, The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China.
ANZ J Surg. 2022 Dec;92(12):3273-3277. doi: 10.1111/ans.17983. Epub 2022 Aug 25.
This study aimed to determine whether the Mayo adhesive probability score (MAP), which evaluated adherent perinephric fat (APF), is useful in evaluating the difficulty of retroperitoneal laparoscopic adrenalectomy (RLA), and to analyse the correlation between MAP and perioperative parameters.
Clinical data of 104 patients with adrenal adenoma who underwent RLA were collected for retrospective analysis. According to the CT images obtained before surgery, patients were divided into two groups: High MAP group (2-5 points) and Low MAP group (0-1 points). Comparison of the general clinical characteristics and the perioperative data between the two groups was made.
There were more male patients (73.7% versus 34.3%), more patients with a smoking history (24.3% versus 7.5%), higher BMI (25.7 versus 23.2, kg/m ), and bigger (23.8 versus 18.5, mm) neoplasm in the high MAP group (P < 0.05). Significant difference was observed in operative time (128.8 versus 102.3, min), estimated blood loss (47.2 versus 25.2, ml) and drainage tube removal time (4.0 versus 3.2, d) between the two groups (P < 0.05). A high MAP score (P < 0.001) and the size of tumour (P = 0.024) were independent risk factors for extended operative time. A higher BMI (OR = 1.525, P < 0.001) and larger tumour size (OR = 2.862, P = 0.004) were independent risk factors for a high MAP score.
MAP score was associated with the perioperative outcomes of RLA. BMI and tumour size were better indicators of MAP score, which can influence the difficulty of RLA.
本研究旨在确定评估黏附性肾周脂肪(APF)的 Mayo 黏附概率评分(MAP)是否有助于评估腹膜后腹腔镜肾上腺切除术(RLA)的难度,并分析 MAP 与围手术期参数之间的相关性。
回顾性分析 104 例接受 RLA 的肾上腺腺瘤患者的临床资料。根据术前 CT 图像,将患者分为高 MAP 组(2-5 分)和低 MAP 组(0-1 分)。比较两组的一般临床特征和围手术期资料。
高 MAP 组男性患者(73.7% vs. 34.3%)、有吸烟史患者(24.3% vs. 7.5%)、BMI 较高(25.7 vs. 23.2,kg/m )和肿瘤较大(23.8 vs. 18.5,mm)(P < 0.05)。两组手术时间(128.8 与 102.3,min)、估计出血量(47.2 与 25.2,ml)和引流管拔除时间(4.0 与 3.2,d)差异有统计学意义(P < 0.05)。MAP 评分高(P < 0.001)和肿瘤大小(P=0.024)是手术时间延长的独立危险因素。较高的 BMI(OR=1.525,P < 0.001)和较大的肿瘤大小(OR=2.862,P=0.004)是 MAP 评分升高的独立危险因素。
MAP 评分与 RLA 的围手术期结果相关。BMI 和肿瘤大小是 MAP 评分的更好指标,会影响 RLA 的难度。