Clinical significance of the application of MAP score for the choice of approach in partial nephrectomy

ZHAO Rui-ning; ZHOU Jian; NIE Li-hong; SHAN Guang-ming; WANG Tao

doi:10.3969/j.issn.1001-9448.2018.02.010

Abstract：Objective To investigate the clinical significance of MAP score in the choice of approach for partial nephrectomy.Methods A retrospective analysis was conducted on the clinical data of 126 patients with renal neoplasms undergoing partial nephrectomy,including 68 cases of open partial nephrectomy(OPN)and 58 cases of laparoscopic par-tial nephrectomy(LPN),in General Hospital of Ningxia Medical University from January 2011 to December 2016.The patients were divided into low -MAP group(0~1),moderate-MAP group(2~3)and high-MAP group(4~5)ac-cording to preoperative CT images.The operative time,estimated blood loss, ischemia time, length of hospital stay and change in creatinine among different MAP groups with different operation approaches were compared.Results The MAP score was significantly associated with the operation approach and postoperative complications(P<0.05).In low-MAP group,compared with OPN patients, ischemia time and change in creatinine were increased, whereas blood loss and length of stay were reduced in the LPN patients.In moderate-MAP group, compared with the OPN patients, operative time and ischemia time were increased,while blood loss and length of stay were reduced in the LPN patients.In high -MAP group,compared with the OPN patients,operative time was increased in LPN patients.Among patients with OPN, compared with low-MAP group,operative time was increased in high -MAP group.Among patients with LPN,compared with low-MAP group,operative time,estimated blood loss and length of stay were increased in high -MAP group.Con-clusion MAP score can be used to choose the approach for partial nephrectomy.Renal neoplasms patients with low or moderate MAP tend to choose LPN,whereas renal neoplasms patients with high -MAP tend to choose OPN.