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The Mayo Adhesive Probability score can help predict intra- and postoperative complications in patients undergoing laparoscopic donor nephrectomy
Purpose Living donor nephrectomy is a high-stake procedure involving healthy individuals, therefore every effort should be made to define each patient’s individualized risk and improve potential donors’ information. The aim of this study was to evaluate the interest of the Mayo adhesive probability...
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| Published in: | World journal of urology 2021-07, Vol.39 (7), p.2775-2781 |
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| creator | Franquet, Quentin Matillon, Xavier Terrier, Nicolas Rambeaud, Jean-Jacques Crouzet, Sebastien Long, Jean-Alexandre Fassi-Fehri, Hakim Codas-Duarte, Ricardo Poncet, Delphine Jouve, Thomas Noble, Johan Malvezzi, Paolo Rostaing, Lionel Descotes, Jean-Luc Badet, Lionel Fiard, Gaelle |
| description | Purpose
Living donor nephrectomy is a high-stake procedure involving healthy individuals, therefore every effort should be made to define each patient’s individualized risk and improve potential donors’ information. The aim of this study was to evaluate the interest of the Mayo adhesive probability (MAP) score, an imaging-based score initially designed to estimate the risk of adherent perinephric fat in partial nephrectomy, to predict intra- and postoperative complications of living donor nephrectomy.
Materials and methods
We retrospectively reviewed the imaging, clinical, and follow-up data of 452 kidney donors who underwent laparoscopic donor nephrectomy in two academic centers.
Results
Imaging and follow-up data were available for 307 kidney donors, among which 44 (14%) had a high MAP score (≥ 3). Intraoperative difficulties were encountered in 50 patients (16%), including difficult dissection (
n =
35) and bleeding (
n =
17). Conversion to open surgery was required for 13 patients (4.2%). On multivariate analysis, a MAP score ≥ 3 was significantly associated with the risk of intraoperative difficulty [OR 14.12 (5.58–35.7),
p
|
| doi_str_mv | 10.1007/s00345-020-03513-4 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_hal_p</sourceid><recordid>TN_cdi_hal_primary_oai_HAL_hal_03001269v1</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2557675714</sourcerecordid><originalsourceid>FETCH-LOGICAL-c453t-366d876f214423002d51f37bf7089340d7d665c68eea30d5d5561c6814122e53</originalsourceid><addsrcrecordid>eNp9kU2PUyEUhonROLX6B1wYEje6uHr4vl02k9ExqdFF94QC7WVyLyDcTtKf4T-W2nFMXLiCA895-XgQek3gAwFQHysA46IDCh0wQVjHn6AF4Yx1vaLyKVqAorzjq55doRe13gEQJUE8R1eMESUogQX6uR08_mpOCa_d4Gu49_h7STuzC2OYT7jaVDy2JuLBjxnn4l2wMw5xLqbDJjqcU51T9sXM516bpjwG24oUa8NwblMf54qP0flySCEe8GiyKalF52CxSzEVHH0eirdzmk4v0bO9Gat_9TAu0fbTzfb6ttt8-_zler3pLBds7piUrldyTwnnlAFQJ8ieqd1eQb9iHJxyUgore-8NAyecEJK0knBCqRdsid5fYgcz6lzCZMpJJxP07Xqjz2vQQgmVq3vS2HcXNpf04-jrrKdQrR9HE306Vk25WEnaK1ANffsPepeOJbaHaCqEkkqoZmiJ6IWy7R9q8fvHGxDQZ7f64lY3t_q3W31uevMQfdxN3j22_JHZAHYBatuKB1_-nv2f2F-8Xq9M</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2557675714</pqid></control><display><type>article</type><title>The Mayo Adhesive Probability score can help predict intra- and postoperative complications in patients undergoing laparoscopic donor nephrectomy</title><source>Springer Nature</source><creator>Franquet, Quentin ; Matillon, Xavier ; Terrier, Nicolas ; Rambeaud, Jean-Jacques ; Crouzet, Sebastien ; Long, Jean-Alexandre ; Fassi-Fehri, Hakim ; Codas-Duarte, Ricardo ; Poncet, Delphine ; Jouve, Thomas ; Noble, Johan ; Malvezzi, Paolo ; Rostaing, Lionel ; Descotes, Jean-Luc ; Badet, Lionel ; Fiard, Gaelle</creator><creatorcontrib>Franquet, Quentin ; Matillon, Xavier ; Terrier, Nicolas ; Rambeaud, Jean-Jacques ; Crouzet, Sebastien ; Long, Jean-Alexandre ; Fassi-Fehri, Hakim ; Codas-Duarte, Ricardo ; Poncet, Delphine ; Jouve, Thomas ; Noble, Johan ; Malvezzi, Paolo ; Rostaing, Lionel ; Descotes, Jean-Luc ; Badet, Lionel ; Fiard, Gaelle</creatorcontrib><description>Purpose
Living donor nephrectomy is a high-stake procedure involving healthy individuals, therefore every effort should be made to define each patient’s individualized risk and improve potential donors’ information. The aim of this study was to evaluate the interest of the Mayo adhesive probability (MAP) score, an imaging-based score initially designed to estimate the risk of adherent perinephric fat in partial nephrectomy, to predict intra- and postoperative complications of living donor nephrectomy.
Materials and methods
We retrospectively reviewed the imaging, clinical, and follow-up data of 452 kidney donors who underwent laparoscopic donor nephrectomy in two academic centers.
Results
Imaging and follow-up data were available for 307 kidney donors, among which 44 (14%) had a high MAP score (≥ 3). Intraoperative difficulties were encountered in 50 patients (16%), including difficult dissection (
n =
35) and bleeding (
n =
17). Conversion to open surgery was required for 13 patients (4.2%). On multivariate analysis, a MAP score ≥ 3 was significantly associated with the risk of intraoperative difficulty [OR 14.12 (5.58–35.7),
p
< 0.001] or conversion to open surgery [OR 18.96 (3.42–105.14),
p
= 0.0042]. Postoperative complications were noted in 99 patients (32%), including 12 patients (3.9%) with Clavien–Dindo grade III–IV complications. On multivariate analysis, a high MAP score was also associated with the risk of postoperative complications [OR 2.55 (1.20–5.40),
p
= 0.01].
Conclusions
In this retrospective bicentric study, a high MAP score was associated with the risk of intra- and postoperative complications of laparoscopic donor nephrectomy. The MAP score appears of interest in the living donor evaluation process to help improve donors’ information and outcomes.</description><identifier>ISSN: 0724-4983</identifier><identifier>EISSN: 1433-8726</identifier><identifier>DOI: 10.1007/s00345-020-03513-4</identifier><identifier>PMID: 33175210</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Female ; Human health and pathology ; Humans ; Intraoperative Complications ; Kidneys ; Laparoscopy ; Life Sciences ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Multivariate analysis ; Nephrectomy ; Nephrectomy - adverse effects ; Nephrectomy - methods ; Nephrology ; Oncology ; Organ donors ; Original Article ; Patients ; Postoperative Complications ; Retrospective Studies ; Surgery ; Tissue and Organ Harvesting - methods ; Urology</subject><ispartof>World journal of urology, 2021-07, Vol.39 (7), p.2775-2781</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020</rights><rights>2020. Springer-Verlag GmbH Germany, part of Springer Nature.</rights><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2020.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c453t-366d876f214423002d51f37bf7089340d7d665c68eea30d5d5561c6814122e53</citedby><cites>FETCH-LOGICAL-c453t-366d876f214423002d51f37bf7089340d7d665c68eea30d5d5561c6814122e53</cites><orcidid>0000-0003-3049-5318 ; 0000-0002-5130-7286 ; 0000-0001-5812-6771</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33175210$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-03001269$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Franquet, Quentin</creatorcontrib><creatorcontrib>Matillon, Xavier</creatorcontrib><creatorcontrib>Terrier, Nicolas</creatorcontrib><creatorcontrib>Rambeaud, Jean-Jacques</creatorcontrib><creatorcontrib>Crouzet, Sebastien</creatorcontrib><creatorcontrib>Long, Jean-Alexandre</creatorcontrib><creatorcontrib>Fassi-Fehri, Hakim</creatorcontrib><creatorcontrib>Codas-Duarte, Ricardo</creatorcontrib><creatorcontrib>Poncet, Delphine</creatorcontrib><creatorcontrib>Jouve, Thomas</creatorcontrib><creatorcontrib>Noble, Johan</creatorcontrib><creatorcontrib>Malvezzi, Paolo</creatorcontrib><creatorcontrib>Rostaing, Lionel</creatorcontrib><creatorcontrib>Descotes, Jean-Luc</creatorcontrib><creatorcontrib>Badet, Lionel</creatorcontrib><creatorcontrib>Fiard, Gaelle</creatorcontrib><title>The Mayo Adhesive Probability score can help predict intra- and postoperative complications in patients undergoing laparoscopic donor nephrectomy</title><title>World journal of urology</title><addtitle>World J Urol</addtitle><addtitle>World J Urol</addtitle><description>Purpose
Living donor nephrectomy is a high-stake procedure involving healthy individuals, therefore every effort should be made to define each patient’s individualized risk and improve potential donors’ information. The aim of this study was to evaluate the interest of the Mayo adhesive probability (MAP) score, an imaging-based score initially designed to estimate the risk of adherent perinephric fat in partial nephrectomy, to predict intra- and postoperative complications of living donor nephrectomy.
Materials and methods
We retrospectively reviewed the imaging, clinical, and follow-up data of 452 kidney donors who underwent laparoscopic donor nephrectomy in two academic centers.
Results
Imaging and follow-up data were available for 307 kidney donors, among which 44 (14%) had a high MAP score (≥ 3). Intraoperative difficulties were encountered in 50 patients (16%), including difficult dissection (
n =
35) and bleeding (
n =
17). Conversion to open surgery was required for 13 patients (4.2%). On multivariate analysis, a MAP score ≥ 3 was significantly associated with the risk of intraoperative difficulty [OR 14.12 (5.58–35.7),
p
< 0.001] or conversion to open surgery [OR 18.96 (3.42–105.14),
p
= 0.0042]. Postoperative complications were noted in 99 patients (32%), including 12 patients (3.9%) with Clavien–Dindo grade III–IV complications. On multivariate analysis, a high MAP score was also associated with the risk of postoperative complications [OR 2.55 (1.20–5.40),
p
= 0.01].
Conclusions
In this retrospective bicentric study, a high MAP score was associated with the risk of intra- and postoperative complications of laparoscopic donor nephrectomy. The MAP score appears of interest in the living donor evaluation process to help improve donors’ information and outcomes.</description><subject>Adult</subject><subject>Female</subject><subject>Human health and pathology</subject><subject>Humans</subject><subject>Intraoperative Complications</subject><subject>Kidneys</subject><subject>Laparoscopy</subject><subject>Life Sciences</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Nephrectomy</subject><subject>Nephrectomy - adverse effects</subject><subject>Nephrectomy - methods</subject><subject>Nephrology</subject><subject>Oncology</subject><subject>Organ donors</subject><subject>Original Article</subject><subject>Patients</subject><subject>Postoperative Complications</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Tissue and Organ Harvesting - methods</subject><subject>Urology</subject><issn>0724-4983</issn><issn>1433-8726</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kU2PUyEUhonROLX6B1wYEje6uHr4vl02k9ExqdFF94QC7WVyLyDcTtKf4T-W2nFMXLiCA895-XgQek3gAwFQHysA46IDCh0wQVjHn6AF4Yx1vaLyKVqAorzjq55doRe13gEQJUE8R1eMESUogQX6uR08_mpOCa_d4Gu49_h7STuzC2OYT7jaVDy2JuLBjxnn4l2wMw5xLqbDJjqcU51T9sXM516bpjwG24oUa8NwblMf54qP0flySCEe8GiyKalF52CxSzEVHH0eirdzmk4v0bO9Gat_9TAu0fbTzfb6ttt8-_zler3pLBds7piUrldyTwnnlAFQJ8ieqd1eQb9iHJxyUgore-8NAyecEJK0knBCqRdsid5fYgcz6lzCZMpJJxP07Xqjz2vQQgmVq3vS2HcXNpf04-jrrKdQrR9HE306Vk25WEnaK1ANffsPepeOJbaHaCqEkkqoZmiJ6IWy7R9q8fvHGxDQZ7f64lY3t_q3W31uevMQfdxN3j22_JHZAHYBatuKB1_-nv2f2F-8Xq9M</recordid><startdate>20210701</startdate><enddate>20210701</enddate><creator>Franquet, Quentin</creator><creator>Matillon, Xavier</creator><creator>Terrier, Nicolas</creator><creator>Rambeaud, Jean-Jacques</creator><creator>Crouzet, Sebastien</creator><creator>Long, Jean-Alexandre</creator><creator>Fassi-Fehri, Hakim</creator><creator>Codas-Duarte, Ricardo</creator><creator>Poncet, Delphine</creator><creator>Jouve, Thomas</creator><creator>Noble, Johan</creator><creator>Malvezzi, Paolo</creator><creator>Rostaing, Lionel</creator><creator>Descotes, Jean-Luc</creator><creator>Badet, Lionel</creator><creator>Fiard, Gaelle</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><general>Springer Verlag</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>1XC</scope><scope>VOOES</scope><orcidid>https://orcid.org/0000-0003-3049-5318</orcidid><orcidid>https://orcid.org/0000-0002-5130-7286</orcidid><orcidid>https://orcid.org/0000-0001-5812-6771</orcidid></search><sort><creationdate>20210701</creationdate><title>The Mayo Adhesive Probability score can help predict intra- and postoperative complications in patients undergoing laparoscopic donor nephrectomy</title><author>Franquet, Quentin ; Matillon, Xavier ; Terrier, Nicolas ; Rambeaud, Jean-Jacques ; Crouzet, Sebastien ; Long, Jean-Alexandre ; Fassi-Fehri, Hakim ; Codas-Duarte, Ricardo ; Poncet, Delphine ; Jouve, Thomas ; Noble, Johan ; Malvezzi, Paolo ; Rostaing, Lionel ; Descotes, Jean-Luc ; Badet, Lionel ; Fiard, Gaelle</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c453t-366d876f214423002d51f37bf7089340d7d665c68eea30d5d5561c6814122e53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Female</topic><topic>Human health and pathology</topic><topic>Humans</topic><topic>Intraoperative Complications</topic><topic>Kidneys</topic><topic>Laparoscopy</topic><topic>Life Sciences</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>Nephrectomy</topic><topic>Nephrectomy - adverse effects</topic><topic>Nephrectomy - methods</topic><topic>Nephrology</topic><topic>Oncology</topic><topic>Organ donors</topic><topic>Original Article</topic><topic>Patients</topic><topic>Postoperative Complications</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Tissue and Organ Harvesting - methods</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Franquet, Quentin</creatorcontrib><creatorcontrib>Matillon, Xavier</creatorcontrib><creatorcontrib>Terrier, Nicolas</creatorcontrib><creatorcontrib>Rambeaud, Jean-Jacques</creatorcontrib><creatorcontrib>Crouzet, Sebastien</creatorcontrib><creatorcontrib>Long, Jean-Alexandre</creatorcontrib><creatorcontrib>Fassi-Fehri, Hakim</creatorcontrib><creatorcontrib>Codas-Duarte, Ricardo</creatorcontrib><creatorcontrib>Poncet, Delphine</creatorcontrib><creatorcontrib>Jouve, Thomas</creatorcontrib><creatorcontrib>Noble, Johan</creatorcontrib><creatorcontrib>Malvezzi, Paolo</creatorcontrib><creatorcontrib>Rostaing, Lionel</creatorcontrib><creatorcontrib>Descotes, Jean-Luc</creatorcontrib><creatorcontrib>Badet, Lionel</creatorcontrib><creatorcontrib>Fiard, Gaelle</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Complete (ProQuest Database)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><jtitle>World journal of urology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Franquet, Quentin</au><au>Matillon, Xavier</au><au>Terrier, Nicolas</au><au>Rambeaud, Jean-Jacques</au><au>Crouzet, Sebastien</au><au>Long, Jean-Alexandre</au><au>Fassi-Fehri, Hakim</au><au>Codas-Duarte, Ricardo</au><au>Poncet, Delphine</au><au>Jouve, Thomas</au><au>Noble, Johan</au><au>Malvezzi, Paolo</au><au>Rostaing, Lionel</au><au>Descotes, Jean-Luc</au><au>Badet, Lionel</au><au>Fiard, Gaelle</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Mayo Adhesive Probability score can help predict intra- and postoperative complications in patients undergoing laparoscopic donor nephrectomy</atitle><jtitle>World journal of urology</jtitle><stitle>World J Urol</stitle><addtitle>World J Urol</addtitle><date>2021-07-01</date><risdate>2021</risdate><volume>39</volume><issue>7</issue><spage>2775</spage><epage>2781</epage><pages>2775-2781</pages><issn>0724-4983</issn><eissn>1433-8726</eissn><abstract>Purpose
Living donor nephrectomy is a high-stake procedure involving healthy individuals, therefore every effort should be made to define each patient’s individualized risk and improve potential donors’ information. The aim of this study was to evaluate the interest of the Mayo adhesive probability (MAP) score, an imaging-based score initially designed to estimate the risk of adherent perinephric fat in partial nephrectomy, to predict intra- and postoperative complications of living donor nephrectomy.
Materials and methods
We retrospectively reviewed the imaging, clinical, and follow-up data of 452 kidney donors who underwent laparoscopic donor nephrectomy in two academic centers.
Results
Imaging and follow-up data were available for 307 kidney donors, among which 44 (14%) had a high MAP score (≥ 3). Intraoperative difficulties were encountered in 50 patients (16%), including difficult dissection (
n =
35) and bleeding (
n =
17). Conversion to open surgery was required for 13 patients (4.2%). On multivariate analysis, a MAP score ≥ 3 was significantly associated with the risk of intraoperative difficulty [OR 14.12 (5.58–35.7),
p
< 0.001] or conversion to open surgery [OR 18.96 (3.42–105.14),
p
= 0.0042]. Postoperative complications were noted in 99 patients (32%), including 12 patients (3.9%) with Clavien–Dindo grade III–IV complications. On multivariate analysis, a high MAP score was also associated with the risk of postoperative complications [OR 2.55 (1.20–5.40),
p
= 0.01].
Conclusions
In this retrospective bicentric study, a high MAP score was associated with the risk of intra- and postoperative complications of laparoscopic donor nephrectomy. The MAP score appears of interest in the living donor evaluation process to help improve donors’ information and outcomes.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>33175210</pmid><doi>10.1007/s00345-020-03513-4</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-3049-5318</orcidid><orcidid>https://orcid.org/0000-0002-5130-7286</orcidid><orcidid>https://orcid.org/0000-0001-5812-6771</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | World journal of urology, 2021-07, Vol.39 (7), p.2775-2781 |
| issn | 0724-4983 1433-8726 |
| language | eng |
| recordid | cdi_hal_primary_oai_HAL_hal_03001269v1 |
| source | Springer Nature |
| subjects | Adult Female Human health and pathology Humans Intraoperative Complications Kidneys Laparoscopy Life Sciences Male Medicine Medicine & Public Health Middle Aged Multivariate analysis Nephrectomy Nephrectomy - adverse effects Nephrectomy - methods Nephrology Oncology Organ donors Original Article Patients Postoperative Complications Retrospective Studies Surgery Tissue and Organ Harvesting - methods Urology |
| title | The Mayo Adhesive Probability score can help predict intra- and postoperative complications in patients undergoing laparoscopic donor nephrectomy |
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