Increased Intra-abdominal Fat Predicts Perioperative Complications Following Minimally Invasive Partial Nephrectomy

Gorin, Michael A.; Mullins, Jeffrey K.; Pierorazio, Phillip M.; Jayram, Gautam; Allaf, Mohamad E.

doi:10.1016/j.urology.2012.12.053

Cited by 43 publications

(45 citation statements)

References 19 publications

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“…Experienced and respected partial nephrectomists have openly commented on the need for a model that predicts the risk of encountering intraoperative APF [7]. Given these difficulties, we aimed to develop a user-friendly scoring system to predict the probability of encountering APF intraoperatively.…”

Section: Discussionmentioning

confidence: 99%

“…Although obesity and increased visceral fat have been linked to increased surgical difficulty and postoperative complications in both radical nephrectomy and PN, there have been limited efforts to determine whether visceral fat can be used to predict the presence of APF [7]. In reply to a recent study in which the authors examined the association of increased abdominal fat (IAF) and perioperative complications, editorials from two experienced partial nephrectomists pointed out the missed opportunity to assess the correlation between increased visceral fat and APF.…”

Section: Introductionmentioning

confidence: 99%

“…In reply to a recent study in which the authors examined the association of increased abdominal fat (IAF) and perioperative complications, editorials from two experienced partial nephrectomists pointed out the missed opportunity to assess the correlation between increased visceral fat and APF. The authors of the editorials went a step further by citing the specific need to elucidate factors that could help surgeons better predict APF as a way to supplement current systems of preoperative risk assessment for PN [7]. A scoring system that could accurately and reliably predict the presence of APF in a preoperative setting would provide a welcomed adjunct to the RENAL, PADUA, and C-index nephrometry scoring systems, enhancing the predictability of surgical complexity for PN and thereby better informing patient selection and improving outcomes.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Mayo Adhesive Probability Score: An Accurate Image-based Scoring System to Predict Adherent Perinephric Fat in Partial Nephrectomy

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Mayo Adhesive Probability Score: An Accurate Image-based Scoring System to Predict Adherent Perinephric Fat in Partial Nephrectomy

et al. 2014

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“…These scoring systems classify tumor complexity based on the imaging findings for tumor-specific factors. In addition to tumor-specific factors, however, surgeons must consider patient-specific factors such as visceral fat, which may be linked to greater surgical difficulty and complications [2]. During PN DOI: 10.1159/000494068 procedures, surgeons sometimes encounter sticky fat around the renal parenchyma which has been designated as adherent perinephric fat (APF).…”

Section: Introductionmentioning

confidence: 99%

Adherent Perinephric Fat in Asian Patients: Predictors and Impact on Perioperative Outcomes of Partial Nephrectomy

Kawamura¹,

Saito²,

Inoue³

et al. 2018

Urol Int

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Introduction: This study is aimed at evaluating the incidence and predictors of adherent perinephric fat (APF) in Asians during partial nephrectomy (PN), and determining the impact of APF on perioperative outcomes. Materials and Methods: A total of 231 Asian patients with renal tumors underwent PN, and their Mayo adhesive probability (MAP) score was calculated. APF was intraoperatively determined, and the perioperative data were compared according to the presence of APF. The predictors of APF were examined using logistic regression analyses. Results: APF was observed in 40 (17%) patients. In multivariate analysis, male gender and higher MAP score were the independent predictors of APF. The estimated blood loss was higher in patients with APF, however, the complication rates did not differ between the 2 groups. Conclusions: The MAP score can predict APF in an Asian population. The presence of APF was associated with greater blood loss; however it did not increase the postoperative complications in PN.

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“…Furthermore, obesity makes minimally invasive partial nephrectomy ( MIPN) more challenging, as increasing BMI and intraabdominal fat (IAF) are associated with increased risk of postoperative complications following MIPN. 11 Herein, our aim is to assess the impact of BMI on perioperative and renal functional outcomes in patients undergoing MIPN.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Body Mass Index on Renal Functional Outcomes Following Minimally Invasive Partial Nephrectomy

Richards

Negron

Cohn

et al. 2014

Journal of Endourology

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Objective: To assess the impact of body mass index (BMI) on perioperative and renal functional outcomes in patients undergoing minimally invasive partial nephrectomy (MIPN). 19, 45). There were no differences in demographic, perioperative, or pathologic features between BMI groups. While controlling for gender, race, Charlson comorbidity score, tumor size, and ischemia time, obese class 1 (odds ratio [OR] 4.68, p = 0.019), obese class ‡2 (OR 4.27, p = 0.033), and age (OR 1.06, p = 0.014) were associated with increased risk of CKD stage ‡3; however, higher baseline eGFR (OR 0.91, p < 0.001) was associated with a reduced risk of CKD stage ‡3. While controlling for the same variables, increasing BMI was associated with a significant absolute reduction in eGFR at 1 year (0.38 mL/minute/1.73 m 2 reduction in GFR per 1 kg/m 2 increase in BMI, p = 0.009). Conclusions: MIPN is technically feasible in obese patients with similar perioperative outcomes to nonobese patients. BMI is an independent risk factor for worsening kidney function following MIPN.

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Increased Intra-abdominal Fat Predicts Perioperative Complications Following Minimally Invasive Partial Nephrectomy

Cited by 43 publications

References 19 publications

Mayo Adhesive Probability Score: An Accurate Image-based Scoring System to Predict Adherent Perinephric Fat in Partial Nephrectomy

Mayo Adhesive Probability Score: An Accurate Image-based Scoring System to Predict Adherent Perinephric Fat in Partial Nephrectomy

Adherent Perinephric Fat in Asian Patients: Predictors and Impact on Perioperative Outcomes of Partial Nephrectomy

The Impact of Body Mass Index on Renal Functional Outcomes Following Minimally Invasive Partial Nephrectomy

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