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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| Hauptverfasser: | , , , , , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
February 2023
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| In: |
Urologia internationalis
Year: 2023, Jahrgang: 107, Heft: 2, Pages: 126-133 |
| ISSN: | 1423-0399 |
| DOI: | 10.1159/000527090 |
| Online-Zugang: | 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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| Verfasserangaben: | 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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| 245 | 1 | 0 | |a Perinephric toxic fat: impact on surgical complexity, perioperative outcome, and surgical approach in partial nephrectomy |c 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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| 520 | |a 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. | ||
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