Evaluation Of The Predictive Efficacy Of C-index Score Combined With Map Perirenal Fat Score For Complications After Laparoscopic Partial Nephrectomy

Objective: To evaluate the potential prediction value of Mayo adhesion probability(MAP)score combined with C-index score for postoperative complications after laparoscopic partial nephrectomy.Methods: The clinical data of 136 patients who underwent laparoscopic partial nephrectomy in The Second Hospital of Jilin University from January 2019 to December 2022 were retrospectively analyzed.MAP score and C-index score were calculated by scanning CT and MRI images,and the binary logistic regression model was combined with MAP score and C-index score to predict the complexity of surgery and the probability of postoperative complications.Prediction ability was further assessed using Area under the curve(AUC).Finally,make a column chart to visually demonstrate the joint prediction ability of the two.To evaluate the predictive value of MAP score combined with C-index score for postoperative complications after laparoscopic partial nephrectomy.Results: A total of 136 patients were included.The overall postoperative complication rate was 11.8%(16 cases).MAP score was associated with OT(r=0.414),EBL(r=0.208)and postoperative complications(r=0.213),respectively.However,no similar correlation was observed with Warm Ischemia Time(WIT)(r=0.165).C-index scores were correlated with WIT(r=0.532),OT(r=0.335),postoperative complications(r=0.296),and EBL(r=0.249),respectively.In combination group,WIT(r=0.478),OT(r=0.537),postoperative complications(r=0.317)and EBL(r=0.420)were correlated,and the correlation was higher than that of C-index and MAP scores.MAP score and C-index score were reliable predictors of overall postoperative complications,with area under the curve(AUC)of 0.648 and 0.765,respectively.Combining these two scores resulted in a statistically significant improvement in overall AUC of postoperative complications(AUC = 0.865,C-index VS combined p=0.0014,MAP VS combined p=0.0016).Conclusions: C-index score can evaluate and predict OT,WIT,EBL and postoperative complications of laparoscopic partial nephrectomy,and MAP score has good predictive value for OT,EBL and postoperative complications of laparoscopic partial nephrectomy.Compared with a single scoring system,the combined application of MAP score and C-index score can improve the accuracy of evaluating and predicting the total postoperative complications.The combined application of MAP score and C-index score can better help clinicians to evaluate the difficulty of surgery before surgery,select appropriate surgical strategies and predict the complications after PN.Like C-index scoring,MAP scoring system should be considered and emphasized in preoperative imaging evaluation.