Impact of the adhesive status of perinephric fat on the selection of dissection routes in retroperitoneal laparoscopic adrenalectomy
10.3969/j.issn.1009-8291.2024.06.011
- VernacularTitle:肾周粘连脂肪评分对后腹腔镜肾上腺切除术路径选择的影响
- Author:
Yongliang WANG
1
,
2
;
Wei CHEN
;
Kang CHENG
;
Bohong CHEN
;
Dapeng WU
Author Information
1. 西安交通大学第一附属医院泌尿外科,陕西西安 710061
2. 西乡县人民医院外二科,陕西汉中 723500
- Keywords:
adrenal surgery;
retroperitoneal laparoscopy;
surgical route;
mayo adhesive probability score
- From:
Journal of Modern Urology
2024;29(6):527-532
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the clinical significance of extra-adipose capsule route and intra-adipose capsule route for the resection of benign adrenal tumors with retroperitoneal laparoscopic adrenalectomy(RLA),and to explore the selection of route based on the mayo adhesive probability(MAP)scoring system.Methods Clinical data of 102 patients who received RLA and pathologically diagnosed as benign adrenal tumors during Feb.2015 and Dec.2020 in the First Affiliated Hospital of Xi'an Jiaotong University were retrospectively reviewed,and MAP scores were assessed with the preoperative tomography images.The gross and MAP score stratified perioperative outcomes between extra-adipose capsule route(classical group,n=56)and intra-adipose capsule route(modified group,n=46)were compared respectively.Results All procedures were successfully completed with no conversion to open surgery and with no need for transfusion.There were no significant differences in operation time[(102.1±26.3)min vs.(110.2±32.1)min,P=0.17]and intraoperative blood loss[(53.5±34.0)mL vs.(61.1±48.4)mL,P=0.35]between the two groups.Subgroup analysis based on MAP score showed that for low risk patients(MAP score 0-2),operative results were comparable between the two groups,but for high risk patients(MAP score 3-5),the operation time was significantly shorter[(114.7±20.7)min vs.(137.2±23.0)min,P＜0.01],and blood loss was significantly less[(52.7±33.1)mL vs.(92.8±49.7)mL,P=0.01]in the classical group than in the modified group.Conclusion RLA could be performed with either surgical routes safely and effectively.MAP scoring system could be an effective tool for preoperative surgical route planning.Compared with the modified route,classical route is more suitable for patients with high MAP score to achieve better operative outcomes.
