Adrenalektomide Perioperatif Sonuçların Öngörülmesi: Neden MAP Skoru BMI’dan Daha Önemlidir?

Öz

Amaç: Bu çalışma, adrenalektomide cerrahi zorluğu öngörmede Mayo Adezif olasılık (MAP) skorunun klinik yararını değerlendirmeyi ve performansını vücut kitle indeksi (VKİ) ile karşılaştırmayı amaçlamıştır. Materyal ve metod: 2015-2024 yılları arasında adrenal adenom nedeniyle adrenalektomi uygulanan 161 hasta retrospektif olarak analiz edildi. Hastalar preoperatif MAP skoruna göre düşük (0-1) ve yüksek (2-5) gruplara, VKİ değerine göre ise üç kategoriye (<25, 25-30, >30 kg/m²) ayrıldı. Operasyon süresi, tahmini kan kaybı,hastanede yatış süresi ve dren çekilme zamanı gruplar arasındakarşılaştırıldı. Bulgular: Yüksek MAP skoruna sahip hastalarda operasyonsüresi (140 vs. 100 dakika, p<0,001), kan kaybı (80 vs. 50 mL,p<0,001), hastanede yatış süresi (8 vs. 7 gün, p=0,010) ve drençekilme zamanı (4 vs. 3 gün, p<0,001) anlamlı olarak dahafazlaydı. VKİ kategorileri arasında ise bu parametreler açısındananlamlı fark saptanmadı. Sonuç: MAP skoru, adrenalektomide cerrahi zorluklarınöngörülmesinde pratik bir preoperatif risk sınıflama aracı olup,cerrahi karmaşıklığın öngörülmesinde VKİ’ye kıyasla dahagüvenilir sonuçlar sağlamaktadır.

Anahtar Kelimeler

• Adrenalektomi
• Mayo Adezif olasılık skoru
• Perioperatif sonuçlar
• Vücut kitle indeksi

Perioperative Outcome Prediction in Adrenalectomy: Why MAP Score Matters More Than BMI?

Öz

Background: This study aimed to evaluate the clinical utility of the Mayo Adhesive probability (MAP) score in predicting surgical difficulty in adrenalectomy and to compare its performance with body mass index (BMI). Materials and Methods: We retrospectively analyzed 161 patients who underwent adrenalectomy for adrenal adenomas between 2015 and 2024. Patients were categorized into low (0-1) and high (2-5) MAP score groups, and into three BMI categories (<25, 25-30, >30 kg/m²). Operative time, estimated blood loss, hospital stay, and drain removal time were compared across groups. Results: Patients with high MAP scores had significantly longer operative times (140 vs. 100 minutes, p<0.001), greater blood loss (80 vs. 50 mL, p<0.001), longer hospital stays (8 vs. 7 days, p=0.010), and delayed drain removal (4 vs. 3 days, p<0.001). No significant differences were observed across BMI categories. Conclusions: The MAP score is a practical preoperative tool for risk stratification in adrenalectomy, providing more reliable prediction of surgical complexity than BMI.

Anahtar Kelimeler

• Adrenalectomy
• Mayo Adhesive probability score
• Body mass index
• Perioperative outcomes

Kaynakça

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