A Combination Of Mayo Adhesive Probability Score And R.E.N.A.L. Score To Predict Intra-operative Complications In Nephron-sparing Surgery

Objective: To evaluate the potential predictive value of Mayo Adhesive Probability(MAP)score upon intra-operative outcomes in retroperitoneal laparoscopic nephron-sparing surgery(NSS)among Eastern Asia population and combine with RENAL score.Methods: An initial of 388 patients undergoing retroperitoneal laparoscopic NSS were identified.MAP score and RENAL score were calculated according to CT scan and a logistic regression model was adopted as combination of RENAL score and MAP score.Results: A total of 293 patients were included.An overall intra-operative complication rate was 7.5%(22 cases).MAP score was found to correlate with operation time(OT,r = 0.169),estimated blood loss(EBL,r= 0.318)and intra-operative complication(r = 0.242).RENAL score was correlated with warm ischemia time(WIT,r= 0.503),OT(r=0.334),intra-operative complication(r= 0.178)and EBL(r= 0.218).MAP score and RENAL score were reliable predictors of overall intra-operative complications with AUCs of 0.728 and 0.759,respectively.After the combination of these two scores,AUC of overall intra-operative complication 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: MAP score is an important predictor of EBL,OT and intra-operative complications in retroperitoneal laparoscopic NSS and the combination with RENAL score shows superiority predictive value than single score in overall intra-operative complications.MAP score might be considered in the pre-operative radiologic aspects as regularly as RENAL score.