Predictive Performance of ADRENAL and MAP Scores for Complications in Laparoscopic Adrenalectomy

Background: The ADRENAL and Mayo Adhesive Probability scores are preoperative composite tools designed to estimate surgical complexity in adrenal surgery. This study aimed to compare their predictive performance for postoperative complications in patients undergoing laparoscopic adrenalectomy. Methods: We retrospectively analyzed 90 patients who underwent transperitoneal laparoscopic adrenalectomy (74 total, 16 partial) between Jul 2019 and Jul 2023. Perioperative outcomes were compared across score groups. Logistic regression and ROC curve analyses were used to assess predictors and discriminative ability. Results: Postoperative complications occurred in 8 patients (8.9%), all Clavien-Dindo grade I-II. On multivariate analysis, both the ADRENAL Score (OR 2.220, 95% CI 1.303-3.781; p < 0.001) and Mayo Adhesive Probability score (OR 7.055, 95% CI 1.204-41.355; p = 0.021) were independent predictors of complications. ROC analysis demonstrated superior discriminative accuracy for the ADRENAL Score (AUC 0.877) over the Mayo Adhesive Probability score (AUC 0.735). Conclusion: Both scoring systems may be useful for predicting postoperative complications following laparoscopic adrenalectomy. The ADRENAL Score demonstrated superior predictive performance and may serve as a more reliable preoperative risk stratification tool in this setting.