Presented by: Altug Tuncel Prof.
University of Health Sciences School of Medicine, Ankara State Hospital, Department of Urology

Introduction

Adherent perinephric fat (APF) may negatively influence on perioperative surgical outcomes of transperitoneal laparoscopic adrenal surgery. The Mayo Adhesive Probability (MAP) score is derived from preoperative cross-sectional imaging measurements to detect APF. This study aimed to determine whether the MAP score can predict the perioperative outcomes in transperitoneal laparoscopic total and partial adrenalectomy.

Materials

Clinical data of 139 patients (82 female and 57 male) who underwent transperitoneal laparoscopic total (n=116) or partial (n=23) adrenalectomy between March 2013 and September 2022 were retrospectively analysed. According to the images obtained from preoperative contrast enhanced computed tomography or magnetic resonance imaging, patients were divided into two groups: Low MAP group (0-1 points) and high MAP group (2-5 points). General clinical features and perioperative outcomes were compared between the groups. In addition, regression analyses were performed to determine association between perioperative outcomes and clinical parameters.

Results

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In patients with high MAP score; mean Body Mass Index (BMI), tumor size, operative time, estimated blood loss (EBL) and complication rate were found significantly higher compared to patients with low MAP score (Table 1). Comparison of the patients in two sub-groups as total and partial adrenalectomy revealed that in both subgroups, operative time and EBL were significantly higher in high MAP score group. Moreover, complication rate in the total adrenalectomy sub-group was significantly higher in the high MAP score group compared to the other (Table 2). Multivariable analyses revealed that high MAP score was an independent risk factor for complication rate. However, according to our results no significant effect of high MAP score on operative time, EBL and postoperative hospital stay duration was found (Table 3).

Conclusion

Our results suggest that high MAP score should be considered as an independent risk factor for complications of laparoscopic total and partial adrenalectomy. In addition, we found no association between high MAP score with operative time, EBL and postoperative hospital stay duration.

Funding

None

Lead Authors

Altug Tuncel, Prof.
University of Health Sciences School of Medicine, Ankara State Hospital, Department of Urology

Co-Authors

Altug Tuncel, Prof.
University of Health Sciences School of Medicine, Ankara State Hospital, Department of Urology

Tanju Keten, MD
University of Health Sciences School of Medicine, Ankara State Hospital, Department of Urology

Zeynep Erhuner, MD
University of Health Sciences School of Medicine, Ankara State Hospital, Department of Radiology

Cagdas Senel, MD
Balıkesir University School of Medicine, Department of Urology

Ali Yasin Ozercan, MD
Ministry of Health, Sirnak State Hospital, Department of Urology

Burak Koseoglu, MD
University of Health Sciences School of Medicine, Ankara State Hospital, Department of Urology

Serdar Basboga, MD
University of Health Sciences School of Medicine, Ankara State Hospital, Department of Urology

Muharrem Tola, MD
University of Health Sciences School of Medicine, Ankara State Hospital, Department of Radiology

Karabekir Ercan, MD
University of Health Sciences School of Medicine, Ankara State Hospital, Department of Radiology

Ozer Guzel, Prof.
University of Health Sciences School of Medicine, Ankara State Hospital, Department of Urology