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

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 pa...

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Main Authors: Walach, Margarete (Author) , Schiefelbein, Frank (Author) , Schneller, Andreas (Author) , Schoen, Georg (Author) , von Klot, Christoph A.J. (Author) , Katzendorn, Olga (Author) , Mühlbauer, Julia (Author) , Nuhn, Philipp (Author) , Kriegmair, Maximilian (Author) , Harke, Nina Natascha (Author)
Format: Article (Journal)
Language:English
Published: February 2023
In: Urologia internationalis
Year: 2023, Volume: 107, Issue: 2, Pages: 126-133
ISSN:1423-0399
DOI:10.1159/000527090
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1159/000527090
Verlag, lizenzpflichtig, Volltext: https://karger.com/uin/article/107/2/126/835412/Perinephric-Toxic-Fat-Impact-on-Surgical
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Author Notes: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
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Summary: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.
Item Description:Online veröffentlicht: 24. November 2022
Gesehen am 29.07.2024
Physical Description:Online Resource
ISSN:1423-0399
DOI:10.1159/000527090

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