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

Area of Science:

• Urology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Laparoscopic partial nephrectomy (LPN) is a standard treatment for localized renal tumors.
• Assessing surgical complexity preoperatively is crucial for patient selection and surgical planning.
• The Mayo adhesive probability (MAP) score is a novel tool to evaluate tumor-adhesiveness.

Purpose of the Study:

• To investigate the association between the Mayo adhesive probability (MAP) score and surgical complexity during LPN.
• To determine if the MAP score can predict operative time, dissection time, and estimated blood loss (EBL).

Main Methods:

• Retrospective analysis of 318 patients undergoing LPN between January 2017 and December 2018.
• Patients were stratified into lower (MAP ≤2) and higher (MAP ≥3) score groups.
• Perioperative outcomes, including operative time, dissection time, warm ischemia time (WIT), and EBL, were compared.

Main Results:

• Higher MAP scores were significantly associated with longer operative times (131 vs. 110 minutes, p<0.001) and increased dissection times (71 vs. 54 minutes, p<0.001).
• Patients with higher MAP scores experienced greater estimated blood loss (50 vs. 20 mL, p<0.001).
• Warm ischemia time (WIT) did not differ significantly between groups (21 vs. 20 minutes, p=0.370).
• Multivariate analysis identified male gender, body mass index, and MAP score as predictors of prolonged dissection time.

Conclusions:

• The MAP score is a significant predictor of increased dissection time during LPN.
• Higher MAP scores indicate greater surgical complexity, leading to longer operative times and increased blood loss.
• The MAP score can aid in preoperative risk stratification and surgical planning for LPN.