Mayo adhesive probability score predicts perioperative outcomes of laparoscopic adrenalectomy: a systematic review and meta-analysis

Objective This meta-analysis aims to systematically evaluate the association between the Mayo Adhesive Probability (MAP) score and perioperative outcomes of laparoscopic adrenalectomy (LA) for benign adrenal tumors, and to explore the value of the MAP score in preoperative risk stratification. Method A comprehensive literature search was conducted in Embase, PubMed, Cochrane Library, and Web of Science from inception to June 1, 2025, to identify studies investigating the correlation between MAP score and LA outcomes. Eligible studies were selected based on predefined criteria, and data extraction was performed independently by two reviewers. The primary outcomes included operative time (OT), estimated blood loss (EBL), length of stay (LOS), and postoperative complications. In addition, baseline and clinicopathological characteristics, including body mass index (BMI), gender distribution, hormonal activity, diabetes mellitus history, and hypertension history, were compared between the study-defined higher MAP and lower MAP groups. Meta-analysis was performed using Stata 16.0. Results A total of 5 retrospective studies involving 578 patients were included. A meta-analysis showed that, compared with the low MAP score group, the high MAP score group had significantly longer OT, higher EBL, and a higher risk of complications. No significant difference in LOS was observed between the two groups. Additionally, the high MAP score group had a higher BMI, a higher proportion of male patients, and more frequent hormonal activity. There were no significant differences in the history of diabetes mellitus or hypertension between the groups. Conclusions Higher MAP scores were associated with longer operative time, greater estimated blood loss, and a higher complication rate in laparoscopic adrenalectomy, while no significant difference in length of stay was observed. The MAP score may be a useful adjunct for preoperative risk assessment, although prospective validation is still needed.