Open and Laparoscopic Partial Nephrectomy: Comparison and Validation of Preoperative Scoring Systems, Including PADUA, RENAL, ABC Nephrometric Scores and Perinephric Fat Evaluation with Mayo Adhesive Probability Score

Abstract Background Adherent perinephric fat (APF), characterized by inflammatory fat surrounding the kidney, can limit the isolation of renal tumors and increase the operative difficulty in laparoscopic partial nephrectomy (LPN). The aim of this study was to investigate the predictors of APF and its impact on perioperative outcomes during LPN. Methods A total of 215 consecutive patients undergoing LPN for renal cell carcinoma (RCC) from January 2017 to June 2019 at our institute were included. We divided these patients into two groups according to the presence of APF. Radiographic data were retrospectively collected from preoperative cross-sectional imaging. The perioperative clinical parameters were compared between the two groups. Univariate and multivariate analyses were performed to evaluate the predictive factors of APF. Results APF was identified in 41 patients (19.1%) at the time of LPN. Univariate analysis demonstrated that APF was significantly correlated with the male gender (P = 0.001), higher body mass index (P = 0.002), lower preoperative estimated glomerular filtration rate (P = 0.004), greater posterior perinephric fat thickness (P< 0.001), greater perinephric stranding (P< 0.001), and higher Mayo Adhesive Probability (MAP) score (P< 0.001). The MAP score (P< 0.001) was the only variable that remained an independent predictor for APF in multivariate analysis. We found that patients with APF had longer operative times (P< 0.001), warm ischemia times (P = 0.001), and greater estimated blood loss (P = 0.003) than those without APF. However, there were no significant differences in surgical approach, transfusion rate, length of postoperative stay, complication rate, or surgical margin between the two groups. Conclusions Several specific clinical and radiographic factors including the MAP score can predict APF. The presence of APF is associated with an increased operative time, warm ischemia time, and greater estimated blood loss but has no impact on other perioperative outcomes in LPN.

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Mayo Adhesive Probability Score Is an Independent Computed Tomography Scan Predictor of Adherent Perinephric Fat in Open Partial Nephrectomy

Urology ◽

10.1016/j.urology.2016.11.043 ◽

2017 ◽

Vol 103 ◽

pp. 124-128 ◽

Cited By ~ 12

Author(s):

Logan Martin ◽

Olivier Rouviere ◽

Riadh Bezza ◽

Jérôme Bailleux ◽

Fatima Abbas ◽

...

Keyword(s):

Computed Tomography ◽

Partial Nephrectomy ◽

Computed Tomography Scan ◽

Open Partial Nephrectomy ◽

Probability Score ◽

Perinephric Fat ◽

Tomography Scan

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Study on the correlation between preoperative inflammatory indexes and adhesional perinephric fat before laparoscopic partial nephrectomy

BMC Urology ◽

10.1186/s12894-021-00940-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Teng Ma ◽

Lin Cong ◽

Qianli Ma ◽

Zhaoqin Huang ◽

Qianqian Hua ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Partial Nephrectomy ◽

Renal Cell ◽

Operation Time ◽

Laparoscopic Partial Nephrectomy ◽

Inflammatory Index ◽

Logistic Regression Method ◽

The Difference ◽

Perinephric Fat

Abstract Objective This study was aimed to evaluate the effect of preoperative composite inflammatory index on adhesional perinephric fat (APF), providing a help for preoperative risk assessment of laparoscopic partial nephrectomy (LPN) in patients with renal cell carcinoma. Materials and methods A retrospective study was conducted on 231 patients with renal cell carcinoma, who underwent laparoscopic partial nephrectomy. They were divided into two groups according to whether there was APF during operation. Relevant clinical data, laboratory parameters and imaging examination were obtained before operation to calculate the composite inflammatory index and MAP score. The composite inflammatory index was divided into high value group and low value group by ROC curve method. The related predictive factors of APF were analyzed by logistic regression method. Results The APF was found in 105 patients (45.5%). In multivariate analysis, systemic immune inflammation index (SII) (high/low), MAP score, tumor size and perirenal fat thickness were independent predictors of APF. The operation time of patients with APF was longer, and the difference of blood loss was not statistically significant. Conclusion SII is an independent predictor of APF before laparoscopic partial nephrectomy. Trial registration ChiCTR, ChiCTR2100045944. Registered 30 April 2021—Retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=125703.

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The Mayo Adhesive Probability Score Predicts Longer Dissection Time During Laparoscopic Partial Nephrectomy

Journal of Endourology ◽

10.1089/end.2019.0687 ◽

2020 ◽

Vol 34 (5) ◽

pp. 594-599 ◽

Cited By ~ 1

Author(s):

Yuanxin Yao ◽

Yansheng Xu ◽

Liangyou Gu ◽

Kan Liu ◽

Pin Li ◽

...

Keyword(s):

Partial Nephrectomy ◽

Laparoscopic Partial Nephrectomy ◽

Probability Score

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The utilization of intraoperative ultrasound in overcoming adherent perinephric fat In laparoscopic partial nephrectomy

European Urology ◽

10.1016/s0302-2838(21)00964-7 ◽

2021 ◽

Vol 79 ◽

pp. S801-S802

Author(s):

M. Gulsen ◽

E. Özden ◽

İ. Çamlıdağ ◽

S. Öner ◽

Y. Bostancı ◽

...

Keyword(s):

Partial Nephrectomy ◽

Intraoperative Ultrasound ◽

Laparoscopic Partial Nephrectomy ◽

Perinephric Fat

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Editorial Comment to Clinical analysis of the PADUA and the RENAL scoring systems for renal neoplasms: A retrospective study of 245 patients undergoing laparoscopic partial nephrectomy

International Journal of Urology ◽

10.1111/iju.12199 ◽

2013 ◽

Vol 21 (1) ◽

pp. 44-45

Author(s):

Riccardo Autorino ◽

Marco De Sio

Keyword(s):

Retrospective Study ◽

Editorial Comment ◽

Partial Nephrectomy ◽

Scoring Systems ◽

Clinical Analysis ◽

Laparoscopic Partial Nephrectomy ◽

Renal Neoplasms

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Clinical analysis of the PADUA and the RENAL scoring systems for renal neoplasms: A retrospective study of 245 patients undergoing laparoscopic partial nephrectomy

International Journal of Urology ◽

10.1111/iju.12192 ◽

2013 ◽

Vol 21 (1) ◽

pp. 40-44 ◽

Cited By ~ 17

Author(s):

Zhong-Yuan Zhang ◽

Qi Tang ◽

Xue-Song Li ◽

Qian Zhang ◽

Wesley A Mayer ◽

...

Keyword(s):

Retrospective Study ◽

Partial Nephrectomy ◽

Scoring Systems ◽

Clinical Analysis ◽

Laparoscopic Partial Nephrectomy ◽

Renal Neoplasms

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Analysis of Predictors of Adherent Perinephric fat and its Impact on Perioperative Outcomes in Laparoscopic Partial Nephrectomy: A Retrospective Case-control Study

10.21203/rs.3.rs-144111/v1 ◽

2021 ◽

Author(s):

Lu Fang ◽

Huan Li ◽

Tao Zhang ◽

Rui Liu ◽

Taotao Zhang ◽

...

Keyword(s):

Blood Loss ◽

Partial Nephrectomy ◽

Univariate Analysis ◽

Warm Ischemia ◽

Laparoscopic Partial Nephrectomy ◽

Renal Tumors ◽

Perioperative Outcomes ◽

Transfusion Rate ◽

Estimated Blood Loss ◽

Perinephric Fat

Abstract Background: Adherent perinephric fat (APF), characterized by inflammatory fat surrounding the kidney, can limit the isolation of renal tumors and increase the operative difficulty in laparoscopic partial nephrectomy (LPN). The aim of this study was to investigate the predictors of APF and its impact on perioperative outcomes during LPN.Methods: A total of 215 consecutive patients undergoing LPN for renal cell carcinoma (RCC) from January 2016 to June 2019 at our institute were included. We divided these patients into two groups according to the presence of APF. Radiographic data were retrospectively collected from preoperative cross-sectional imaging. The perioperative clinical parameters were compared between the two groups. Univariate and multivariate analyses were performed to evaluate the predictive factors of APF. Results: APF was observed in 41 patients (19.1%) at the time of LPN. Univariate analysis demonstrated that APF was significantly correlated with male gender (P = 0.001), higher body mass index (P = 0.002), lower preoperative estimated glomerular filtration rate (P = 0.004), greater posterior perinephric fat thickness (P < 0.001), greater perinephric stranding (P < 0.001) and higher Mayo Adhesive Probability (MAP) score (P < 0.001). The MAP score (P < 0.001) was the only variable that remained an independent predictor for APF in multivariate analysis. We found that patients with APF had longer operative times (P < 0.001), warm ischemia times (P = 0.001), and greater estimated blood loss (P = 0.003) than those without APF. However, there were no significant differences in surgical approach, transfusion rate, length of postoperative stay, complication rate or surgical margin between the two groups.Conclusions: Several specific clinical and radiographic factors including the MAP score can predict APF. The presence of APF is associated with an increased operative time, and warm ischemia time and greater estimated blood loss but has no impact on other perioperative outcomes in LPN.

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