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World Journal of Urology

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01-11-2015 | Original Article

Analysis of the impact of adherent perirenal fat on peri-operative outcomes of robotic partial nephrectomy

Authors: Zine-Eddine Khene, Benoit Peyronnet, Romain Mathieu, Tarek Fardoun, Grégory Verhoest, Karim Bensalah

Published in: World Journal of Urology | Issue 11/2015

Abstract

Introduction

Adherent perirenal fat (APF) can be defined as inflammatory fat sticking to renal parenchyma, whose dissection is difficult and makes it troublesome to expose the tumour. Our objective was to evaluate the impact of APF on the technical difficulty of robot-assisted partial nephrectomy (RPN).

Patients and methods

We analysed data of 202 patients who underwent RPN for a small renal tumour. Patients were divided into two groups according to the presence of APF. Peri-operative data were compared between the two groups. Predictors of APF were evaluated by univariate and multivariate analysis. The validity of the MAP score (radiological scoring system) was also assessed.

Results

APF was observed in 80 patients (39.6 %). Tumour complexity and surgeon’s experience were similar between both groups. Operative time was 40 min longer in the APF group (188.5 vs. 147.9 min, p < 0.0001). Blood loss was twice higher, and transfusions were more common in the APF group (694 vs. 330 ml, p < 0.0001 and 19 vs. 5.8 %, p = 0.003, respectively). APF was associated with an increased risk of conversion to open surgery (11.2 vs. 0 %, p = 0.0002) or radical nephrectomy (6.2 vs. 0.8 %, p = 0.03). In multivariate analysis, male gender (OR 13.2, p < 0.0001), obesity (OR 1.2, p = 0.007), hypertension (OR 3.7, p = 0.02), and MAP score (OR 3.3; p < 0.0001) were significant predictors of APF.

Conclusion

During RPN, APF is associated with increased bleeding and a higher risk of conversion to open surgery and to radical nephrectomy. Male gender, hypertension, obesity, and MAP score are predictors of APF.

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Title: Analysis of the impact of adherent perirenal fat on peri-operative outcomes of robotic partial nephrectomy
Authors: Zine-Eddine Khene
Benoit Peyronnet
Romain Mathieu
Tarek Fardoun
Grégory Verhoest
Karim Bensalah
Publication date: 01-11-2015
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 11/2015
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-015-1500-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Analysis of the impact of adherent perirenal fat on peri-operative outcomes of robotic partial nephrectomy

Abstract

Introduction

Patients and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Patients and methods

Results

Conclusion

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