Impact of adherent perirenal fat on laparoscopic nephron sparing surgery

Abstract

Objective To study the effect of adherent perirenal fat (APF) on laparoscopic nephron sparing surgery (NSS). Methods A total of 94 cases of laparoscopic NSS in our hospital from November 2015 to November 2017 were collected and were divided into APF group and non-APF group according to intraoperative conditions. Preoperative variables and operation time, intraoperative blood loss, transfusion rate, positive margins, warm ischemia time, rate of conversion to open surgery, drainage time after surgery, and postoperative hospital stay were compared between the two groups. Results The incidence of APF was 36.2% (34/60), more common in males and obese patients. The appearance of APF significantly prolonged the operation time [(148.8±22.6)min vs.(108.7±18.9)min, P=0.000], increased intraoperative blood loss [(399.1±239.9)ml vs.(270.8±184.9)ml, P=0.005], transfusion rate (38.2% vs.18.3%, P=0.033), rate of conversion to open surgery (26.5% vs.8.3%, P=0.018), postoperative drainage time [(4.3±0.9)d vs.(3.1±0.6)d, P=0.000], and postoperative hospital stay [(7.9±1.4)d vs.(6.3±0.8)d, P=0.000]. There were no statistically significant differences in positive margins and warm ischemia time between the two groups (P>0.05). Conclusion APF makes it difficult to isolate the tumor in laparoscopic NSS, which increases the difficulty of operation but does not affect the effect of tumor resection. Key words: Laparoscopic nephron sparing surgery; Adherent perirenal fat