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Kallidonis P, Spinos T, Zondervan P, Nyirády P, Backhaus MR, Micali S, Hruby S, Alvarez-Maestro M, Tatanis V, Liatsikos E, Gözen AS. Predictive Value of the Mayo Adhesive Probability (MAP) Score in Laparoscopic Partial Nephrectomies: A Systematic Review from the EAU Section of Uro-Technology (ESUT). Cancers (Basel) 2024; 16:1455. [PMID: 38672537 PMCID: PMC11048046 DOI: 10.3390/cancers16081455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/03/2024] [Accepted: 04/06/2024] [Indexed: 04/28/2024] Open
Abstract
The Mayo Adhesive Probability (MAP) score is a radiographic scoring system that predicts the presence of adherent perinephric fat (APF) during partial nephrectomies (PNs). The purpose of this systematic review is to summarize the current literature on the application of the MAP score for predicting intraoperative difficulties related to APF and complications in laparoscopic PNs. Three databases, PubMed, Scopus and Cochrane, were screened, from inception to 29 October 2023, taking into consideration the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guidelines. All the inclusion criteria were met by eight studies. The total operative time was around two hours in most studies, while the warm ischemia time was <30 min in all studies and <20 min in four studies. Positive surgical margins, conversion and transfusion rates ranged from 0% to 6.3%, from 0% to 5.0% and from 0.7% to 7.5%, respectively. Finally, the majority of the complications were classified as Grade I-II, according to the Clavien-Dindo Classification System. The MAP score is a useful tool for predicting not only the presence of APF during laparoscopic PNs but also various intraoperative and postoperative characteristics. It was found to be significantly associated with an increased operative time, estimated blood loss and intraoperative and postoperative complication rates.
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Affiliation(s)
- Panagiotis Kallidonis
- Department of Urology, University of Patras Hospital, 26504 Patras, Greece; (T.S.); (V.T.); (E.L.)
- Laparoscopy Working Group, European Association of Urology (EAU) Section of Uro-Technology; (P.Z.); (P.N.); (M.R.B.); (S.M.); (S.H.); (M.A.-M.); (A.S.G.)
| | - Theodoros Spinos
- Department of Urology, University of Patras Hospital, 26504 Patras, Greece; (T.S.); (V.T.); (E.L.)
| | - Patricia Zondervan
- Laparoscopy Working Group, European Association of Urology (EAU) Section of Uro-Technology; (P.Z.); (P.N.); (M.R.B.); (S.M.); (S.H.); (M.A.-M.); (A.S.G.)
- Department of Urology, Amsterdam Medical Centers, 1081 Amsterdam, The Netherlands
| | - Peter Nyirády
- Laparoscopy Working Group, European Association of Urology (EAU) Section of Uro-Technology; (P.Z.); (P.N.); (M.R.B.); (S.M.); (S.H.); (M.A.-M.); (A.S.G.)
- Department of Urology, Semmelweis University Budapest, 1083 Budapest, Hungary
| | - Miguel Ramírez Backhaus
- Laparoscopy Working Group, European Association of Urology (EAU) Section of Uro-Technology; (P.Z.); (P.N.); (M.R.B.); (S.M.); (S.H.); (M.A.-M.); (A.S.G.)
- Department of Urology, Fundación Instituto Valenciano de Oncología, 46009 Valencia, Spain
| | - Salvatore Micali
- Laparoscopy Working Group, European Association of Urology (EAU) Section of Uro-Technology; (P.Z.); (P.N.); (M.R.B.); (S.M.); (S.H.); (M.A.-M.); (A.S.G.)
- Department of Urology, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Stephan Hruby
- Laparoscopy Working Group, European Association of Urology (EAU) Section of Uro-Technology; (P.Z.); (P.N.); (M.R.B.); (S.M.); (S.H.); (M.A.-M.); (A.S.G.)
- Department of Urology, Tauernklinikum Paracelsusstrasse 8, Zell/See, 5700 Salzburg, Austria
| | - Mario Alvarez-Maestro
- Laparoscopy Working Group, European Association of Urology (EAU) Section of Uro-Technology; (P.Z.); (P.N.); (M.R.B.); (S.M.); (S.H.); (M.A.-M.); (A.S.G.)
- Department of Urology, Hospital Universitario La Paz, 28046 Madrid, Spain
| | - Vasileios Tatanis
- Department of Urology, University of Patras Hospital, 26504 Patras, Greece; (T.S.); (V.T.); (E.L.)
| | - Evangelos Liatsikos
- Department of Urology, University of Patras Hospital, 26504 Patras, Greece; (T.S.); (V.T.); (E.L.)
- Department of Urology, Medical University of Vienna, 1090 Vienna, Austria
| | - Ali Serdar Gözen
- Laparoscopy Working Group, European Association of Urology (EAU) Section of Uro-Technology; (P.Z.); (P.N.); (M.R.B.); (S.M.); (S.H.); (M.A.-M.); (A.S.G.)
- Department of Urology, Medius-Kliniken Ruit, University of Tubingen, 73760 Ostfildern, Germany
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Zeng Z, Ge S, Li Y, Gan L, Meng C, Li K, Wang Z, Zheng L. Mayo Adhesion Probability Score Predicts Perioperative Outcome of Partial Nephrectomy: A Systematic Review and Meta-Analysis. J Endourol 2024; 38:240-252. [PMID: 38185844 DOI: 10.1089/end.2023.0419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024] Open
Abstract
Objective: Assessing whether Mayo adhesive probability (MAP) levels affect perioperative outcomes after partial nephrectomy (PN). Methods: This systematic review and meta-analysis were conducted in accordance with the PRISMA statement. A systematic search of the literature published before February 1, 2023 was conducted using Pubmed, Embase, Cochran, and Web of Science libraries. We included all articles evaluating adherent perirenal fat by MAP during PN. Results: A total of 1807 patients from 7 studies meeting the criteria were included. In the high MAP group, the operation time was longer, and the estimated blood loss and postoperative complications were increased. There was no significant difference in positive surgical margin, warm ischemia time, and hospitalization time. Conclusions: As a simple and easy scoring method, MAP can predict the perioperative outcome of PN patients, especially when ≥3 is the boundary. However, more cohort studies are still needed to determine the optimal cutoff point of MAP.
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Affiliation(s)
- Zhiqiang Zeng
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, Sichuan, China
- Department of Urology, School of Clinical Medicine, Southwest Medical University, Luzhou, China
| | - Si Ge
- Department of Urology, School of Clinical Medicine, Southwest Medical University, Luzhou, China
| | - Yunxiang Li
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, Sichuan, China
- Department of Urology, School of Clinical Medicine, Southwest Medical University, Luzhou, China
| | - Lijian Gan
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, Sichuan, China
| | - Chunyang Meng
- Department of Urology, School of Clinical Medicine, Southwest Medical University, Luzhou, China
| | - Kangsen Li
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, Sichuan, China
| | - Zuoping Wang
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, Sichuan, China
| | - Lei Zheng
- Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, Sichuan, China
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Nakanishi Y, Hirose K, Yasujima R, Umino Y, Okubo N, Kataoka M, Yajima S, Masuda H. Impact of perinephric fat volume and the Mayo Adhesive Probability score on time to clamping in robot-assisted partial nephrectomy. J Robot Surg 2023:10.1007/s11701-023-01544-8. [PMID: 36788149 DOI: 10.1007/s11701-023-01544-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 02/04/2023] [Indexed: 02/16/2023]
Abstract
The aim of this study is to evaluate the association of perinephric fat volume (PNFV) and the Mayo Adhesive Probability (MAP) score with time to clamping (TTC) in robot-assisted partial nephrectomy (RAPN). The study subjects consisted of 73 tumors in 72 patients who underwent transperitoneal RAPN at a single cancer center between February 2020 and July 2022. Clinical characteristics including R.E.N.A.L. nephrometry score, MAP score and PNFV were evaluated in a multivariate analysis in relation to TTC, which was classified into two groups based on median TTC. PNFV and MAP score were analyzed separately. PNFVs were measured by SYNAPSE VINCENT® by a single expert urologist. Median TTC was 67 (range: 36-119) min. Spearman's rank correlation analysis indicated that a significant correlation was observed between PNFV and MAP score with a value of 0.81 (p < 0.0001). Univariate analysis revealed that R.E.N.A.L. nephrometry score ≥ 7 (p = 0.036), posterior tumor location (p = 0.033), MAP score ≥ 3 (p = 0.02) and PNFV ≥ 250 ml (p = 0.02) were significant factors for prolonged TTC. In a multivariate analysis including PNFV (analysis 1), R.E.N.A.L. nephrometry score ≥ 7 (OR 3.54, p = 0.018) and PNFV ≥ 250cm3 (OR 3.94, p = 0.010) were independent factors for prolonged TTC. Similarly for MAP score (analysis 2), R.E.N.A.L. nephrometry score ≥ 7 (OR 3.54, p = 0.018) and MAP score ≥ 3 (OR 3.94, p = 0.010) were independent factors for prolonged TTC. Both MAP score and PNFV may have a significant impact on TTC.
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Affiliation(s)
- Yasukazu Nakanishi
- Department of Urology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa-shi, Chiba, 277-8577, Japan.
| | - Kohei Hirose
- Department of Urology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa-shi, Chiba, 277-8577, Japan
| | - Rikuto Yasujima
- Department of Urology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa-shi, Chiba, 277-8577, Japan
| | - Yosuke Umino
- Department of Urology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa-shi, Chiba, 277-8577, Japan
| | - Naoya Okubo
- Department of Urology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa-shi, Chiba, 277-8577, Japan
| | - Madoka Kataoka
- Department of Urology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa-shi, Chiba, 277-8577, Japan
| | - Shugo Yajima
- Department of Urology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa-shi, Chiba, 277-8577, Japan
| | - Hitoshi Masuda
- Department of Urology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa-shi, Chiba, 277-8577, Japan
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Gülşen M, Özden E, Çamlıdağ İ, Öner S, Bostancı Y, Yakupoğlu YK, Yılmaz AF, Sarıkaya Ş. Intraoperative Ultrasound Can Facilitate Laparoscopic Partial Nephrectomy in Adherent Perinephric Fat. J Laparoendosc Adv Surg Tech A 2023; 33:480-486. [PMID: 36689198 DOI: 10.1089/lap.2022.0535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Background: Adherent perinephric fat (APF) is one of the challenging factors of laparoscopic partial nephrectomy (LPN). The aim of this study was to investigate the effect of intraoperative laparoscopic ultrasound (ILUS) on determining renal tumor localization and dissection in patients with APF who underwent LPN. Methods: Prospectively collected data from 517 patients who underwent LPN from October 2010 to September 2020 in tertiary university hospital were evaluated retrospectively. The cohort was divided into two main groups according to the Mayo Adhesive Probability (MAP) score: Group 1 (MAP score ≤3) and Group 2 (MAP score ≥4). After implementing propensity score-matched analysis including the complexity of tumor, age, and body mass index, Group 1 consisted of 202 patients with ≤3 MAP score and Group 2 included 46 patients. Then, both groups were allocated into two subgroups according to whether ILUS was used. Demographics, perioperative features such as perirenal fatty tissue dissection, tumor excision, operation time, and perioperative outcomes accepted as trifecta, considering warm ischemia time, negative surgical margin, and complications were compared. Results: In Group 1, ILUS use did not seem to affect perioperative outcomes in both subgroups. However, ILUS has a positive effect on perirenal fatty tissue dissection (10 versus 19 minutes, P = .011), tumor excision (4 versus 7 minutes, P = .005), and operation time (78 versus 90 minutes, P = .046) in Group 2. Trifecta outcomes were also better in higher MAP scores and ultrasound-used subgroups (P = .019). Conclusions: ILUS should be considered a helpful and effective instrument in overcoming APF in LPN. It might also have a positive effect on trifecta outcomes.
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Affiliation(s)
- Murat Gülşen
- Department of Urology, Samsun Gazi State Hospital, İlkadım, Samsun, Turkey.,Department of Urology and Faculty of Medicine, Ondokuz Mayıs University, Atakum, Samsun, Turkey
| | - Ender Özden
- Department of Urology and Faculty of Medicine, Ondokuz Mayıs University, Atakum, Samsun, Turkey
| | - İlkay Çamlıdağ
- Department of Radiology, Faculty of Medicine, Ondokuz Mayıs University, Atakum, Samsun, Turkey
| | - Süleyman Öner
- Department of Urology and Faculty of Medicine, Ondokuz Mayıs University, Atakum, Samsun, Turkey.,Department of Urology, Eskişehir Yunus Emre State Hospital, Eskişehir, Turkey
| | - Yakup Bostancı
- Department of Urology and Faculty of Medicine, Ondokuz Mayıs University, Atakum, Samsun, Turkey
| | - Yarkın Kamil Yakupoğlu
- Department of Urology and Faculty of Medicine, Ondokuz Mayıs University, Atakum, Samsun, Turkey
| | - Ali Faik Yılmaz
- Department of Urology and Faculty of Medicine, Ondokuz Mayıs University, Atakum, Samsun, Turkey
| | - Şaban Sarıkaya
- Department of Urology and Faculty of Medicine, Ondokuz Mayıs University, Atakum, Samsun, Turkey
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Yuan Y, Feng H, Kang Z, Xie Y, Zhang X, Zhang Y. Mayo adhesive probability score is associated with perioperative outcomes in retroperitoneal laparoscopic adrenalectomy. ANZ J Surg 2022; 92:3273-3277. [PMID: 36054720 PMCID: PMC10087372 DOI: 10.1111/ans.17983] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 07/31/2022] [Accepted: 08/01/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUNDS This study aimed to determine whether the Mayo adhesive probability score (MAP), which evaluated adherent perinephric fat (APF), is useful in evaluating the difficulty of retroperitoneal laparoscopic adrenalectomy (RLA), and to analyse the correlation between MAP and perioperative parameters. METHODS Clinical data of 104 patients with adrenal adenoma who underwent RLA were collected for retrospective analysis. According to the CT images obtained before surgery, patients were divided into two groups: High MAP group (2-5 points) and Low MAP group (0-1 points). Comparison of the general clinical characteristics and the perioperative data between the two groups was made. RESULTS There were more male patients (73.7% versus 34.3%), more patients with a smoking history (24.3% versus 7.5%), higher BMI (25.7 versus 23.2, kg/m2 ), and bigger (23.8 versus 18.5, mm) neoplasm in the high MAP group (P < 0.05). Significant difference was observed in operative time (128.8 versus 102.3, min), estimated blood loss (47.2 versus 25.2, ml) and drainage tube removal time (4.0 versus 3.2, d) between the two groups (P < 0.05). A high MAP score (P < 0.001) and the size of tumour (P = 0.024) were independent risk factors for extended operative time. A higher BMI (OR = 1.525, P < 0.001) and larger tumour size (OR = 2.862, P = 0.004) were independent risk factors for a high MAP score. CONCLUSIONS MAP score was associated with the perioperative outcomes of RLA. BMI and tumour size were better indicators of MAP score, which can influence the difficulty of RLA.
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Affiliation(s)
- Yeqing Yuan
- Department of Urology, Shenzhen People's Hospital, The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - Huiquan Feng
- Department of Urology, Shenzhen People's Hospital, The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - Zheng Kang
- Department of Urology, Shenzhen People's Hospital, The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - Yunhai Xie
- Department of Urology, Shenzhen People's Hospital, The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - Xueqi Zhang
- Department of Urology, Shenzhen People's Hospital, The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
| | - Yixiang Zhang
- Department of Urology, Shenzhen People's Hospital, The Second Clinical Medical College of Jinan University, The First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China
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Numakura K, Kobayashi M, Koizumi A, Kashima S, Yamamoto R, Nara T, Saito M, Narita S, Inoue T, Habuchi T. Factors influencing warm ischemia time in robot-assisted partial nephrectomy change depending on the surgeon's experience. World J Surg Oncol 2022; 20:202. [PMID: 35701769 PMCID: PMC9199197 DOI: 10.1186/s12957-022-02669-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 06/02/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Warm ischemia time (WIT) is a primary concern for robot-assisted laparoscopic partial nephrectomy (RALPN) patients because longer WIT is significantly associated with postoperative deteriorating kidney function. Tumor complexity, determined by the RENAL nephrometry score (RENAL score), can help predict surgical outcomes, but it is unclear what RENAL score and clinical factors affect WIT. This study explored the clinical factors predicting long WIT in experienced surgeon to RALPN. MATERIALS AND METHODS In our institute, 174 RALPNs were performed between November 2013 and February 2021, of which 114 were performed by a single surgeon and included in this study. Clinical staging and the total RENAL score were determined based on preoperative CT scans. The cases were divided into three groups based on experience: period 1: 1-38, period 2: 39-76, and period 3: 77-114. The clinical factors associated with longer WIT were analyzed per period. RESULTS The overall median tumor diameter was 32 mm, and one patient had a positive surgical margin, but there were no cancer-related deaths. In total, there were 18 complications (15.8%). Periods 2 and 3 had larger tumor diameters (p < 0.01) and worse preoperative kidney function (p = 0.029) than period 1. A RENAL L-component score of 3 was associated with longer WIT in period 3 (odds ratio: 3.900; 95% confidence interval: 1.004-15.276; p = 0.044), but the tumor diameter and the total RENAL score were not. CONCLUSIONS A large tumor in the central lesion indicated by the RENAL L-component score was associated with increased WIT in RALPN.
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Affiliation(s)
- Kazuyuki Numakura
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
| | - Mizuki Kobayashi
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Atsushi Koizumi
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Soki Kashima
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Ryohei Yamamoto
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Taketoshi Nara
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Mitsuru Saito
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Shintaro Narita
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
| | - Takamitsu Inoue
- Department of Urology, International University of Health and Welfare, Narita Hospital, 852 Hatakeda, Narita, 286-0124, Japan
| | - Tomonori Habuchi
- Department of Urology, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan
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Kim H, Kim M, Byun SS, Hong SK, Lee S. Clinical Implication of Adherent Perinephric Fat in Robot-Assisted Partial Nephrectomy: Validation With Video Review. Front Surg 2022; 9:840664. [PMID: 35465429 PMCID: PMC9023756 DOI: 10.3389/fsurg.2022.840664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/01/2022] [Indexed: 11/15/2022] Open
Abstract
Objective To assess the impact of adherent perinephric fat (APF) on perioperative outcomes of robot-assisted partial nephrectomy (RAPN). Methods A total of 562 Asian patients with kidney tumors received RAPN and their Mayo adhesive probability (MAP) scores were evaluated. APF was determined intraoperatively and confirmed by a second surgical video review and perioperative data were compared according to the MAP score. The associations of APF with clinical factors were examined using logistic regression analyses. Subgroup (classified according to who performed the surgery) analysis was conducted to assess if the perirenal dissection time is significantly correlated with APF. Results A total of 118 consecutive patients were classified into two groups according to APF. Patients in the APF group needed significantly longer perirenal fat dissection time (p < 0.001) and longer hospital stay (p = 0.028). MAP score (Odds ratio [OR]: 2.71, 95% Confidence interval [CI]: 1.56–4.71, p < 0.001), body mass index (OR: 1.24, 95% CI: 1.04–1.47, p = 0.016), and perirenal fat dissection time (OR: 1.11, 95% CI: 1.03–1.19, p = 0.004) were significantly associated with the presence of APF. Perirenal fat dissection time was significantly correlated with APF presence in two of three surgeon subgroups (ß = 8.117, p = 0.023; ß = 7.239, p = 0.011). Conclusions Preoperative MAP score and perirenal fat dissection time were significantly associated with APF during RAPN.
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Affiliation(s)
- Hwanik Kim
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Urology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, South Korea
| | - Myeongju Kim
- Center for Artificial Intelligence in Healthcare, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Seok-Soo Byun
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Urology, Seoul National University College of Medicine, Seoul, South Korea
| | - Sung Kyu Hong
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Urology, Seoul National University College of Medicine, Seoul, South Korea
| | - Sangchul Lee
- Department of Urology, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Urology, Seoul National University College of Medicine, Seoul, South Korea
- *Correspondence: Sangchul Lee
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Chen Y, Ma T, Cong L, Xu J, Huang C, Ma Q, Hua Q, Li X, Huang Z, Wang X. Computed tomography-based radiomics nomogram model for predicting adherent perinephric fat. J Cancer Res Ther 2022; 18:336-344. [DOI: 10.4103/jcrt.jcrt_1425_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kira S, Sawada N, Nakagomi H, Ihara T, Furuya R, Takeda M, Mitsui T. Mayo Adhesive Probability Score Is Associated with the Operative Time in Laparoscopic Adrenalectomy. J Laparoendosc Adv Surg Tech A 2021; 32:595-599. [PMID: 34491848 DOI: 10.1089/lap.2021.0459] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Background: Laparoscopic adrenalectomy (LA) is the standard treatment for adrenal benign tumors, including primary aldosteronism (PA) or Cushing's syndrome (CS). Several obesity-related factors were associated with prolonged total operative time (OT), but perinephric fat characteristics were not assessed. We investigated whether the Mayo adhesive probability (MAP) score, which evaluates perinephric fat characteristics, was associated with OT for LA. Methods: This single-center, retrospective cohort study examined 141 consecutive patients who underwent LA for PA or CS. We reviewed patients' characteristics and OT. MAP scores were recorded using preoperative imaging. The correlation among characteristics data, MAP score, and OT was evaluated. Results: Overall, we assessed 82 women and 59 men. Adrenal tumors were found in 80 PA and 61 CS patients. There were 74 left-sided and 67 right-sided tumors. For all patients, the median age, body mass index, and tumor size were 56 years (interquartile range [IQR] 46-65), 24.1 kg/m2 (IQR 21.7-26.8), and 19 mm (IQR 13-26), respectively. A total of 91 patients had MAP scores of 0, and 50 had MAP >0. The median OT was 183.5 minutes (IQR: 156-224 minutes) in the MAP >0 group and 162 minutes (IQR: 135-194 minutes) in the MAP = 0 group. In single variable analysis (unadjusted), MAP scores >0 and left-sided tumors were correlated with longer OT. Multivariable regression analysis revealed that this correlation was only significant for MAP scores >0. Conclusions: MAP score may be useful in preoperative planning for PA or CS patients undergoing LA.
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Affiliation(s)
- Satoru Kira
- Department of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Norifumi Sawada
- Department of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Hiroshi Nakagomi
- Department of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Tatsuya Ihara
- Department of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Ryouta Furuya
- Department of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Masayuki Takeda
- Department of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Yamanashi, Japan
| | - Takahiko Mitsui
- Department of Urology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Chuo, Yamanashi, Japan
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Multislice Spiral CT Image Analysis and Meta-Analysis of Inspiratory Muscle Training on Respiratory Muscle Function. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:1738205. [PMID: 34257847 PMCID: PMC8249157 DOI: 10.1155/2021/1738205] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/06/2021] [Accepted: 06/11/2021] [Indexed: 12/24/2022]
Abstract
Respiratory muscle function has a significant effect on stroke. Stroke is one of the most common cardiovascular and cerebrovascular diseases in the clinic and has a significant impact on the quality of life of patients. Hemiplegia, cerebral hemorrhage, and even death can occur, mainly in the elderly. In this paper, we meta-analyzed the effect of inspiratory muscle training on respiratory muscle function. In this article, we used a topic search method to search for relevant literature on respiratory muscle training and obtained 58 and 32 literature studies from CNKI and Wanfang Data, respectively. As a result of the screening, 36 and 28 documents were obtained. In this paper, 64 selected articles were studied. The authors make statistics on the literature of designing serum content index and multislice spiral CT (Member of the Society of Cardiological Technicians) image of patients, so as to analyze the influence of CT image and inspiratory muscle training on respiratory muscle function. The study showed that FVC, FEV1, MIP, and diaphragm mobility of the experimental group were significantly improved after treatment in more than 85% of the studies (P < 0.05), while those of the control group were not significantly improved (P > 0.05). The comparison between the two groups after treatment showed that FVC, FEV1, MIP, and diaphragm mobility of the experimental group were higher than those of the control group (P < 0.05). The application of multislice spiral CT image analysis technology can effectively evaluate the effect of inspiratory muscle training on respiratory dysfunction in stroke patients, the mechanism of which regulates the expression of related pathways, suppresses the inflammatory response, and can reduce oxidative stress damage. Therefore, respiratory muscle training can improve the function of respiratory muscle and reduce the death rate of cerebellar hemorrhage in patients with stroke and other vascular diseases.
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Correlation Between the Mayo Adhesive Probability Score and the Operative Time in Laparoscopic Donor Nephrectomy. Transplant Proc 2020; 53:793-798. [PMID: 33272653 DOI: 10.1016/j.transproceed.2020.10.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/29/2020] [Accepted: 10/01/2020] [Indexed: 01/15/2023]
Abstract
BACKGROUND Adherent perinephric fat (APF) is a known risk factor of surgical difficulty during laparoscopic donor nephrectomy (LDN). The Mayo Adhesive Probability (MAP) score predicts APF accurately. The aim of this study is to identify the association between MAP score and operative time in LDN. METHODS We retrospectively evaluated 154 kidney donors who underwent surgery from December 2017 to December 2019 at İstanbul Aydın University Hospital and İstinye University Hospital. All of the operations were done by 3 senior surgeons by a fully laparoscopic method. The MAP score was derived from computed tomography scans by 1 blinded reader. Demographic data, body mass index (BMI), MAP score, side selection, estimated glomerular filtration rate (eGFR), number of arteries and veins, operative time, hospital stay, and complications are recorded. Single and multiple variable analyses were used to evaluate the correlation between operative time and MAP score, BMI, side selection, and number of vascular structures. RESULTS A total of 154 patients (79 men, 75 women) with a mean age of 44.4 ± 12.72 were included in this study. None of the cases were converted to open nephrectomy. There were no major complications. Mean BMI was 27.59 ± 4.32 kg/m2, mean MAP score was 0.69 ± 1.15, and mean operative time was 40.25 ± 9.81 minutes. Although mean BMI was higher in women (28.19 ± 4.52 vs 27.03 ± 4.07; P < .05), mean MAP score was lower than in men (0.35 ± 0.86 vs 1.03 ± 1.29; P < .001). Older age, higher BMI, higher MAP score, and presence of multiple renal arteries were associated with longer operative time of LDN. The MAP score was associated with older age, male sex and higher BMI. CONCLUSIONS This study showed that different risk factors can affect operative time in LDN. The MAP score was significantly associated with longer operative time, especially in men, so it can be useful for predicting surgical difficulty in kidney donors.
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