Mayo adhesive probability score is associated with perioperative outcomes in retroperitoneal laparoscopic adrenalectomy

Yuan, Yeqing; Feng, Huiquan; Zheng, Kun; Xie, Yunhai; Zhang, Xueqi; Zhang, Yixiang

doi:10.1111/ans.17983

Cited by 10 publications

(14 citation statements)

References 24 publications

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“…In the same year, Chen et al studied the perioperative outcomes of retroperitoneal LA and recognized MAP as the only factor affecting independently all of the evaluated outcomes (operation time, blood loss, hemoglobin drop) [16]. MAP score was also used by the investigators of a third study to evaluate the factors affecting operation time in retroperitoneal LA [17]. MAP score and tumor size were independent parameters of extended procedure duration.…”

Section: Discussionmentioning

confidence: 99%

Factors predicting adherent periadrenal fat in laparoscopic adrenalectomy

Olcucuoglu

Şenel

Uzun

et al. 2023

Preprint

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Background Adrenalectomy require the anatomic preparation of the adrenal gland in the fat-rich retroperitoneal space. In the literature, it was shown that the retroperitoneal fat area affects surgical outcomes in laparoscopic adrenalectomy (LA). Besides the quantity of retroperitoneal fat, its qualitative properties play hypothetically a significant role in the safety profile and perioperative parameters of LA. In this study, we aimed to evaluate the factors associated with adherent periadrenal fat.Methods The prospectively obtained demographic, preoperative, intraoperative and postoperative data of 44 patients who underwent laparoscopic adrenalectomy in our clinic were analyzed retrospectively. The patients was divided into two groups as adherent periadrenal fat (APAF) and non-APAF group. Periadrenal fat tissue was defined as adherent or non-adherent by the attending surgeon according to the difficulty in dissection of adrenal gland from the surrounding fat tissue during the operation.Results The rate of female gender and presence of diabetes mellitus (DM) was higher in the APAF group (respectively, p = 0.038 and p = 0.001). A ROC curve analysis showed that the cut-off point was − 97 HU for APAF. On multivariable analysis using stepwise regression model, we identified presence of DM (OR = 5.073; 95% Cl = 2.192–12.387; p = 0.006) and ARFD > -97 HU (OR = 3.727; 95% Cl = 1.898–11.454; p = 0.008) as independent predictor of APAF.Conclusion APAF seems to affect the perioperative outcomes of LA in terms of operation duration but not perioperative complications.

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Section: Discussionmentioning

confidence: 99%

Factors predicting adherent periadrenal fat in laparoscopic adrenalectomy

Olcucuoglu

Şenel

Uzun

et al. 2023

Preprint

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“…In total, ten eligible retrospective studies [10][11][12][13][14][15][16][17][18][19] including 3200 patients (1320 patients in high MAP group and 1880 patients in low MAP group) undergoing PN, DN or LA were included. The 10 studies from six countries were published between 2018 and 2022.…”

Section: Study Characteristics and Quality Assessmentmentioning

confidence: 99%

“…Increasing evidence demonstrated that MAP score is a credible and accurate predictor of APF in partial nephrectomy (PN) [4][5][6][7][8] and donor nephrectomy (DN) [9,10]. Recent studies reported that MAP score is associated with perioperative outcomes in PN [11][12][13][14], DN [10,15,16], and Laparoscopic Adrenalectomy(LA) [17][18][19], however, the conclusion among above studies is controversial. Thus, this meta-analysis aimed to explore clinical predictive role of MAP score in patients undergoing PN, DN, and LA.…”

Section: Introductionmentioning

confidence: 99%

Clinical predictive role of Mayo adhesive probability score in nephrectomy and adrenalectomy：A Systematic Review and Meta-analysis

wang

Feng

Zhang

et al. 2023

Preprint

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Purpose This study aimed to determine the clinical predictive role of Mayo adhesive probability (MAP) score in nephrectomy and adrenalectomy. Methods Publications were searched in PubMed, Web of Science, and Embase. Pooled analysis of MAP predictive role of perioperative outcomes including operative times (OT), estimated blood loss (EBL), warm ischemia time (WIT), length of stay (LOS), and complication rate was performed. Weighted mean differences (WMDs) with 95% confidence intervals (CIs) for continuous data and Odds ratio (ORs) with 95% Cis for dichotomous data were considered the effect size. Statistical significance was defined as P-value < 0.05. Results A total of 10 eligible studies including 3200 patients undergoing nephrectomy or adrenalectomy were included. Pooled results of 10 studies showed that OT in high MAP score group were significant longer than those in low MAP score group (WMD = 18.58, 95% CI: [11.44, 25.73], P < 0.00001). Pooled results of 7 studies showed that EBL in high MAP score group were significant greater than those in low MAP score group (WMD = 38.50, 95% CI: [20.44, 56.57], P < 0.0001). Pooled results of 5 studies showed that there was no significant difference on WIT between high MAP score group and low MAP score group (WMD = 0.58, 95% CI: [-0.34, 1.51], P = 0.22). Pooled results of 6 studies showed that there was no significant difference on LOS between high MAP score group and low MAP score group (WMD=-0.07, 95% CI: [-0.39, 0.25], P = 0.67). Pooled results of 7 studies showed that there was no significant difference on complication rate between high MAP score group and low MAP score group (OR = 0.79, 95% CI: [0.57, 1.11], P = 0.18). Conclusion The high MAP score predicts longer operative times and greater estimated blood loss. In other words, the MAP score could predict surgical complexity.

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“…[13] A higher MAP score was associated with the operative time in LA [14,15] , as well as estimated blood loss and drainage tube removal time. [15] It was evident that high BMI or high MAP score affected LA, but which speci c aspects of the surgery were affected and whether MTRLA truly overcomed this challenge remains to be determined. We propose a new concept called adhesive periadrenal fat (APAF) [16] , which is de ned as the presence of image-dense stranding in periadrenal fat, either in the form of thin bars or thick bands.…”

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confidence: 92%

The Modified Retroperitoneal Laparoscopic Adrenalectomy effectively resolves adhesive periadrenal fat and achieves superior outcomes

Hu,

Li,

Cai

et al. 2024

Preprint

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Purpose: The Mayo adhesive probabilityscore affects adrenalectomy outcome. To determine whether modified three-layered retroperitoneal laparoscopic adrenalectomy overcomes periadrenal fat adhesion compared to classic three-layered retroperitoneal laparoscopic adrenalectomy to achieve better surgical outcomes. Materials and Methods: Patients who underwent retroperitoneal laparoscopic adrenalectomy were divided into two groups from January 2016 to December 2022. Baseline characteristics and perioperative data were analyzed, and statistical significance was defined as p<0.05. Linear regression analysis was used for data that met certain conditions, such as linearity, normality, and independence. Binary logistic regression analysis was employed for binary classification of the dependent variables. Results: A total of 731 patients underwent retroperitoneal laparoscopic adrenalectomy, and 651 patients had adequate data for the adhesive probability score assessment. Of these patients, 247 were in the modified group and 404 were in the classic group, and baseline characteristics were comparable between the two groups (p>0.05). The modified group exhibited superior outcomes in terms of the operating time, duration, postoperative hospital stay, estimated blood loss, and complications. Notably, there were 16 cases of unplanned adrenalectomy in the classic group, whereas no such cases occurred in the modified group. Further analysis revealed that periadrenal stranding may be the underlying cause of this discrepancy. Conclusions: The modified three-layered retroperitoneal laparoscopic adrenalectomy effectively overcame the impact of adhesive periadrenal fat compared with the classic approach. We recommend the use of modified three-layered retroperitoneal laparoscopic adrenalectomy for patients with adhesive periadrenal fat.

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Mayo adhesive probability score is associated with perioperative outcomes in retroperitoneal laparoscopic adrenalectomy

Cited by 10 publications

References 24 publications

Factors predicting adherent periadrenal fat in laparoscopic adrenalectomy

Factors predicting adherent periadrenal fat in laparoscopic adrenalectomy

Clinical predictive role of Mayo adhesive probability score in nephrectomy and adrenalectomy：A Systematic Review and Meta-analysis

The Modified Retroperitoneal Laparoscopic Adrenalectomy effectively resolves adhesive periadrenal fat and achieves superior outcomes

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