A Combination of the Mayo Adhesive Probability Score and the RENAL Score to Predict Intraoperative Complications in Small Renal Masses
A Combination of the Mayo Adhesive Probability Score and the RENAL Score to Predict Intraoperative Complications in Small Renal Masses
复制标题
结合 Mayo 粘连概率评分和 RENAL 评分来预测小肾脏肿块的术中并发症
DOI：
10.1159/000504767
复制
发表时间：
2020-04-01
影响因子：
1.6
通讯作者：
Zhang Weili
中科院分区：
文献类型：
--
作者：
Jin Dachun;Zhang Junyong;Zhang Weili
前言：在东亚人群中，评估Mayo黏附概率(MAP)评分和肾脏评分对后腹膜后腹腔镜肾单位保留手术(NSS)术中预后的潜在预测价值。方法：对388例腹膜后腹腔镜NSS患者的临床资料进行分析。根据CT计算平均动脉压(MAP)和平均动脉压(MAP)评分，并采用Logistic回归模型对肾脏评分和MAP评分进行组合。结果：共纳入293例患者。术中并发症发生率为7.5%(21例)。MAP评分与手术时间(OT；r=0.169)、估计出血量(EBL；r=0.318)和术中并发症(r=0.242)相关。肾功能评分与热缺血时间(r=0.503)、超时时间(r=0.334)、术中并发症(r=0.178)、术后恢复时间(r=0.218)相关。MAP评分和肾脏评分是术中并发症的可靠预测指标，曲线下面积(AUC)分别为0.728和0.759。联合应用两种评分后，术中并发症的AUC值均有改善，差异有统计学意义(AUC=0.847，联合评分与肾脏评分：P=0.044；MAP评分：P=0.005；0.05)。结论：MAP评分是预测后腹腔镜NSS术中EBL、OT及术中并发症的重要指标，其与肾脏评分联合应用对术中并发症的预测价值优于单一评分。在术前放射学方面，MAP评分可以和肾脏评分一样有规律地被考虑。
Introduction: To evaluate the potential predictive value of the Mayo Adhesive Probability (MAP) score combined with the RENAL score for intraoperative outcomes in retroperitoneal laparoscopic nephron-sparing surgery (NSS) in an Eastern Asian population. Methods: An initial of 388 patients undergoing retroperitoneal laparoscopic NSS were identified. MAP and RENAL scores were calculated according to CT and a logistic regression model was adopted as a combination of the RENAL score and the MAP score. Results: A total of 293 patients were included. The overall intraoperative complication rate was 7.5% (21 cases). The MAP score was found to correlate with operation time (OT; r = 0.169), estimated blood loss (EBL; r = 0.318), and intraoperative complications (r = 0.242). The RENAL score was correlated with warm ischemia time (r = 0.503), OT (r = 0.334), intraoperative complications (r = 0.178), and EBL (r = 0.218). The MAP score and the RENAL score were reliable predictors of overall intraoperative complications, with areas under the curve (AUC) of 0.728 and 0.759, respectively. After combination of these 2 scores, the AUC of overall intra-operative complications was improved with statistical significance (AUC = 0.847, combination vs. RENAL score: p = 0.044 < 0.05; combination vs. MAP score: p = 0.005 < 0.05). Conclusion: The MAP score is an important predictor of EBL, OT, and intraoperative complications in retroperitoneal laparoscopic NSS and its combination with the RENAL score showed a superior predictive value compared to a single score in overall intraoperative complications. The MAP score might be considered in preoperative radiologic aspects as regularly as the RENAL score.