Perinephric toxic fat: impact on surgical complexity, perioperative outcome, and surgical approach in partial nephrectomy

• Verfasst von: Walach, Margarete [VerfasserIn]
• Verfasst von: Schiefelbein, Frank [VerfasserIn]
• Verfasst von: Schneller, Andreas [VerfasserIn]
• Verfasst von: Schoen, Georg [VerfasserIn]
• Verfasst von: von Klot, Christoph A.J. [VerfasserIn]
• Verfasst von: Katzendorn, Olga [VerfasserIn]
• Verfasst von: Mühlbauer, Julia [VerfasserIn]
• Verfasst von: Nuhn, Philipp [VerfasserIn]
• Verfasst von: Kriegmair, Maximilian [VerfasserIn]
• Verfasst von: Harke, Nina Natascha [VerfasserIn]
• Titel: Perinephric toxic fat: impact on surgical complexity, perioperative outcome, and surgical approach in partial nephrectomy
• Verf.angabe: Margarete Teresa Walach, Frank Schiefelbein, Andreas Schneller, Georg Schoen, Christoph A.J. von Klot, Olga Katzendorn, Julia Mühlbauer, Philipp Nuhn, Maximilian Christian Kriegmair, Nina Natascha Harke
• E-Jahr: 2023
• Jahr: February 2023
• Umfang: 8 S.
• Fussnoten: Online veröffentlicht: 24. November 2022 ; Gesehen am 29.07.2024
• Titel Quelle: Enthalten in: Urologia internationalis
• Ort Quelle: Basel : Karger, 1955
• Jahr Quelle: 2023
• Band/Heft Quelle: 107(2023), 2 vom: Feb., Seite 126-133
• ISSN Quelle: 1423-0399
• DOI: doi:10.1159/000527090
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1896931650

Abstract

Introduction: To assess influencing factors on perinephric toxic fat (high Mayo Adhesive Probability [MAP] score) and the impact of high MAP scores on surgical complexity, perioperative outcome, and surgical approach in patients with localized renal tumors undergoing open (OPN) and robot-assisted partial nephrectomy (RAPN). Methods: 698 patients were included in this study. Based on preoperative imaging, adherent perinephric fat (APF) was assessed to define MAP scores. Regression analyses assessed influencing parameters for high MAP scores (≥3), predictors of surgical outcome, and influencing factors on surgical approach. Results: OPN was performed in 331 (47%) patients, and 367 (53%) patients underwent RAPN. Male gender (p < 0.001), age ≥65 (p < 0.001), and BMI ≥27.4 kg/m2 (p < 0.001) showed to be significantly influencing factors for the presence of APF. High MAP scores showed to be an influencing factor for a prolonged surgery duration (OR = 1.68, 95% CI 1.22-2.31, p = 0.002) and a significant predictor to rather undergo OPN than RAPN (OR = 1.5, 95% CI 1.05-2.15, p = 0.027). Conclusion: Older, male patients with high BMI scores have a higher risk for APF. The presence of APF increases surgery time and may have an impact on decision making regarding the preferred surgical approach.