Background

Retroperitoneal laparoscopic adrenalectomy (RLA) possessing unique superiority with minimal abdominal interference is complicated by the status of periadrenal fat, including its quantity and texture. We hypothesized that an adherent perinephric fat predictor, the Mayo Adhesive Probability score (Mayo score), is associated with the perioperative outcomes of RLA.

Methods

This retrospective study included consecutive patients who underwent RLA for the diagnosis of benign adrenal tumors at our institution between 2017 and 2020. Medical records were reviewed to evaluate the association between Mayo scores obtained from preoperative computed tomography imaging and surgical outcomes as well as complications. Factors independently related to perioperative results were analyzed using multivariable regression models.

Results

In total, 186 RLA were included. According to their Mayo scores, the patients were divided as follows: 0 (n = 51, 27.4%), 1 (n = 34, 18.3%), 2 (n = 45, 24.2%), 3 (n = 29, 15.6%), 4 (n = 16, 8.6%) and 5 (n = 11, 5.9%). Longer operative time (92.0 ± 25.0 vs. 114.7 ± 30.6 vs. 137.4 ± 27.1 min, P < 0.001), higher estimated blood loss (42.2 ± 28.1 vs. 70.5 ± 44.9 vs. 132.6 ± 63.4 mL, P < 0.001) and greater decline of hemoglobin (0.7 ± 0.4 vs. 1.0 ± 0.4 vs. 1.3 ± 0.6 g/dL, P < 0.001) were significantly associated with elevated Mayo score risks. No difference in complication rates was found. The score was identified as a unique, independent risk factor for perioperative outcomes on multivariable analysis.

Conclusions

The Mayo score is a vital outcome predictor of RLA. It may be utilized in the preoperative planning for patients undergoing RLA.

中文翻译：

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粘附性肾周脂肪评分与腹膜后腹腔镜肾上腺切除术治疗良性疾病的结果相关

背景

腹膜后腹腔镜肾上腺切除术 (RLA) 具有独特的优势，腹部干扰最小，但由于肾上腺周围脂肪的状况，包括其数量和质地而变得复杂。我们假设粘附性肾周脂肪预测因子 Mayo 粘附概率评分（Mayo 评分）与 RLA 的围手术期结果相关。

方法

这项回顾性研究纳入了 2017 年至 2020 年间在我们机构接受 RLA 诊断为良性肾上腺肿瘤的连续患者。回顾了病历以评估从术前计算机断层扫描成像获得的 Mayo 评分与手术结果以及并发症之间的关联。使用多变量回归模型分析与围手术期结果独立相关的因素。

结果

总共包括 186 个 RLA。根据他们的梅奥评分，患者分为：0（n  = 51, 27.4%），1（n  = 34, 18.3%），2（n  = 45, 24.2%），3（n  = 29, 15.6 %)、4 ( n  = 16, 8.6%) 和 5 ( n  = 11, 5.9%)。手术时间更长（92.0 ± 25.0 vs. 114.7 ± 30.6 vs. 137.4 ± 27.1 分钟，P  < 0.001），估计失血量更高（42.2 ± 28.1 vs. 70.5 ± 44.9 vs. 132.6 ± 63.4 mL，P  < 0.001）和更高血红蛋白下降（0.7 ± 0.4 对 1.0 ± 0.4 对 1.3 ± 0.6 g/dL，P < 0.001) 与 Mayo 评分风险升高显着相关。并发症发生率没有差异。在多变量分析中，该评分被确定为围手术期结果的独特、独立的危险因素。

结论

Mayo 评分是 RLA 的重要结果预测指标。它可用于接受 RLA 患者的术前计划。