Introduction: The aim of the study was to evaluate the predictive value of Mayo Adhesive Probability (MAP) and the Estimation of Physiologic Ability and Surgical Stress (E-PASS) scores for postoperative complications in laparoscopic total adrenalectomy (LTA) and partial adrenalectomy (LPA). Methods: This study included 140 patients who underwent transperitoneal laparoscopic adrenalectomy at our clinic. Patients were grouped based on the presence (group 1, n = 11) or absence (group 2, n = 129) of complications. Preoperative, perioperative, and postoperative data were collected. A MAP score ≥2 was defined as high. Results: Group 1 had a higher incidence of chronic pulmonary and coronary artery disease (p < 0.001). Operative time and estimated blood loss (EBL) were also significantly greater (p = 0.036 and p = 0.041). High MAP scores were more common in this group (p = 0.008), and E-PASS scores were significantly elevated. Univariate logistic regression analysis revealed predictive value for both MAP and Comprehensive Risk Score (CRS) (OR: 5.8, 95% CI: 1.6–21.1, p = 0.008; OR: 18.77, 95% CI: 4.75–74.3, p = 0.000, respectively) for complications. However, multivariate analysis identified only CRS and EBL as independent predictors (OR: 13.5, 95% CI: 2.26–80.6, p = 0.001 and OR: 1.007, 95% CI: 1.001–1.010, p = 0.013, respectively). Conclusion: The MAP and E-PASS scores are both useful for predicting postoperative complications in patients undergoing LTA and LPA. However, the E-PASS score was found to have independent predictive value for postoperative complications.

1.
Gagner
M
,
Lacroix
A
,
Bolté
E
.
Laparoscopic adrenalectomy in cushing’s syndrome and pheochromocytoma
.
N Engl J Med
.
1992
;
327
(
14
):
1033
.
2.
Walz
MK
,
Peitgen
K
,
Hoermann
R
,
Giebler
RM
,
Mann
K
,
Eigler
FW
.
Posterior retroperitoneoscopy as a new minimally invasive approach for adrenalectomy: results of 30 adrenalectomies in 27 patients
.
World J Surg
.
1996
;
20
(
7
):
769
74
.
3.
Marek-Safiejko
M
,
Safiejko
K
,
Łukaszewicz
J
,
Dadan
J
,
Ładny
RJ
,
Kozłowski
R
, et al
.
A comparison of two approaches to laparoscopic adrenalectomy: lateral transperitoneal versus posterior retroperitoneal approach
.
Adv Clin Exp Med
.
2016
;
25
(
5
):
829
35
.
4.
Brunt
LM
,
Doherty
GM
,
Norton
JA
,
Soper
NJ
,
Quasebarth
MA
,
Moley
JF
.
Laparoscopic adrenalectomy compared to open adrenalectomy for benign adrenal neoplasms
.
J Am Coll Surg
.
1996
;
183
(
1
):
1
10
.
5.
Gagner
M
,
Pomp
A
,
Heniford
BT
,
Pharand
D
,
Lacroix
A
.
Laparoscopic adrenalectomy: lessons learned from 100 consecutive procedures
.
Ann Surg
.
1997
;
226
(
3
):
238
47
.
6.
Del Pizzo
JJ
.
Transabdominal laparoscopic adrenalectomy
.
Curr Urol Rep
.
2003
;
4
(
1
):
81
6
.
7.
Walach
MT
,
Schiefelbein
F
,
Schneller
A
,
Schoen
G
,
von Klot
CAJ
,
Katzendorn
O
, et al
.
Perinephric toxic fat: impact on surgical complexity, perioperative outcome, and surgical approach in partial nephrectomy
.
Urol Int
.
2023
;
107
(
2
):
126
33
.
8.
Kocher
NJ
,
Kunchala
S
,
Reynolds
C
,
Lehman
E
,
Nie
S
,
Raman
JD
.
Adherent perinephric fat at minimally invasive partial nephrectomy is associated with adverse peri-operative outcomes and malignant renal histology
.
BJU Int
.
2016
;
117
(
4
):
636
41
.
9.
Chen
Y
,
Scholten
A
,
Chomsky-Higgins
K
,
Nwaogu
I
,
Gosnell
JE
,
Seib
C
, et al
.
Risk factors associated with perioperative complications and prolonged length of stay after laparoscopic adrenalectomy
.
JAMA Surg
.
2018
;
153
(
11
):
1036
41
.
10.
Erbil
Y
,
Barbaros
U
,
Sari
S
,
Agcaoglu
O
,
Salmaslioglu
A
,
Ozarmagan
S
.
The effect of retroperitoneal fat mass on surgical outcomes in patients performing laparoscopic adrenalectomy: the effect of fat tissue in adrenalectomy
.
Surg Innov
.
2010
;
17
(
2
):
114
9
.
11.
Pearlstein
SS
,
Kuo
JH
,
Chabot
JA
,
Lee
JA
.
Periadrenal volume is a better predictor of prolonged operative time in laparoscopic retroperitoneal adrenalectomy than BMI
.
World J Surg
.
2020
;
44
(
2
):
578
84
.
12.
Davidiuk
AJ
,
Parker
AS
,
Thomas
CS
,
Leibovich
BC
,
Castle
EP
,
Heckman
MG
, et al
.
Mayo adhesive probability score: an accurate image-based scoring system to predict adherent perinephric fat in partial nephrectomy
.
Eur Urol
.
2014
;
66
(
6
):
1165
71
.
13.
Haga
Y
,
Ikei
S
,
Ogawa
M
.
Estimation of Physiologic Ability and Surgical Stress (E-PASS) as a new prediction scoring system for postoperative morbidity and mortality following elective gastrointestinal surgery
.
Surg Today
.
1999
;
29
(
3
):
219
25
.
14.
Chen
W
,
Fang
Q
,
Ding
S
,
Wu
X
,
Zhang
P
,
Cao
J
, et al
.
The adhesive perinephric fat score is correlated with outcomes of retroperitoneal laparoscopic adrenalectomy for benign diseases
.
World J Surg
.
2022
;
46
(
11
):
2687
94
.
15.
Kira
S
,
Sawada
N
,
Nakagomi
H
,
Ihara
T
,
Furuya
R
,
Takeda
M
, et al
.
Mayo adhesive probability score is associated with the operative time in laparoscopic adrenalectomy
.
J Laparoendosc Adv Surg Tech
.
2022
;
32
(
6
):
595
9
.
16.
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
(
12
):
3273
7
.
17.
Tuncel
A
,
Keten
T
,
Senel
C
,
Erhuner Tengirsenk
Z
,
Ozercan
AY
,
Koseoglu
B
, et al
.
Can the Mayo adhesive probability score predict perioperative outcomes in laparoscopic total and partial adrenalectomy
.
J Endourol
.
2024
;
38
(
2
):
142
9
.
18.
Dindo
D
,
Demartines
N
,
Clavien
PA
.
Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey
.
Ann Surg
.
2004
;
240
(
2
):
205
13
.
19.
Tuncel
A
,
Balci
M
,
Aykanat
C
,
Aslan
Y
,
Berker
D
,
Guzel
O
.
Laparoscopic partial adrenalectomy using near-infrared imaging: the initial experience
.
Minim Invasive Ther Allied Technol
.
2021
;
30
(
2
):
94
100
.
20.
Hamilton
BD
.
Laparoscopic adrenalectomy
. In:
Bishoff
JT
,
Kavoussi
LR
, editors.
Atlas of laparoscopic urologic surgery
.
Philadelphia
:
Saunders
;
2007
. p.
214
27
.
21.
Janetschek
G
,
Finkenstedt
G
,
Gasser
R
,
Waibel
UG
,
Peschel
R
,
Bartsch
G
, et al
.
Laparoscopic surgery for pheochromocytoma: adrenalectomy, partial resection, exc of paragangliomas
.
J Urol
.
1998
;
160
(
2
):
330
4
.
22.
Kaye
DR
,
Storey
BB
,
Pacak
K
,
Pinto
PA
,
Linehan
WM
,
Bratslavsky
G
.
Partial adrenalectomy: underused first line therapy for small adrenal tumors
.
J Urol
.
2010
;
184
(
1
):
18
25
.
23.
Balci
M
,
Tuncel
A
,
Aslan
Y
,
Aykanat
C
,
Berker
D
,
Guzel
O
.
Laparoscopic partial versus total adrenalectomy in nonhereditary unilateral adrenal masses
.
Urol Int
.
2020
;
104
(
1–2
):
75
80
.
24.
Rowe
NE
,
Kumar
R
,
Schieda
N
,
Siddiqi
F
,
McGregor
T
,
McAlpine
K
, et al
.
Diagnosis, management, and follow-up of the incidentally discovered adrenal mass: cua guideline endorsed by the AUA
.
J Urol
.
2023
;
210
(
4
):
590
9
.
25.
Lorenz
K
,
Langer
P
,
Niederle
B
,
Alesina
P
,
Holzer
K
,
Nies
C
, et al
.
Surgical therapy of adrenal tumors: guidelines from the German Association of Endocrine Surgeons (CAEK)
.
Langenbecks Arch Surg
.
2019
;
404
(
4
):
385
401
.
26.
Oka
Y
,
Nishijima
J
,
Oku
K
,
Azuma
T
,
Inada
K
,
Miyazaki
S
, et al
.
Usefulness of an Estimation of Physiologic Ability And Surgical Stress (E-PASS) scoring system to predict the incidence of postoperative complications in gastrointestinal surgery
.
World J Surg
.
2005
;
29
(
8
):
1029
33
.
27.
Yilmaz
AB
,
Karimzada
K
,
Ozercan
AY
,
Yurdakul
O
,
Keten
T
,
Guzel
O
, et al
.
Comparison of different scoring systems for prediction of postoperative complications after robot-assisted radical prostatectomy
.
J Robot Surg
.
2025
;
19
(
1
):
272
.
28.
Kayra
MV
,
Deniz
ME
,
Ozer
C
,
Guvel
S
,
Senel
S
.
Estimation of Physiologic Ability and Surgical Stress (E-PASS) predicts postoperative complications after radical cystectomy
.
Int Urol Nephrol
.
2024
;
56
(
12
):
3743
9
.
29.
Celen
S
,
Simsek
A
,
Duran
MB
,
Kucuker
K
,
Saglam
B
,
Celik
O
, et al
.
Prediction of complications after laparoscopic partial nephrectomy: feasibility of E-PASS score
.
Int Urol Nephrol
.
2025
;
57
(
3
):
701
8
.
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