MP67-13 PURE HOST-RELATED RISK FACTORS FOR ADHERENT PERINEPHRIC FAT IN HEALTHY INDIVIDUALS DURING LAPAROSCOPIC RENAL SURGERY

Abstract

You have accessJournal of UrologyKidney Cancer: Epidemiology & Evaluation/Staging II1 Apr 2017MP67-13 PURE HOST-RELATED RISK FACTORS FOR ADHERENT PERINEPHRIC FAT IN HEALTHY INDIVIDUALS DURING LAPAROSCOPIC RENAL SURGERY Shintaro Narita, Takamitsu Inoue, Mitsuru Saito, Taketoshi Nara, Koichiro Takayama, Kazuyuki Numakura, Hiroshi Tsuruta, Atsushi Maeno, Shigeru Satoh, and Tomonori Habuchi Shintaro NaritaShintaro Narita More articles by this author , Takamitsu InoueTakamitsu Inoue More articles by this author , Mitsuru SaitoMitsuru Saito More articles by this author , Taketoshi NaraTaketoshi Nara More articles by this author , Koichiro TakayamaKoichiro Takayama More articles by this author , Kazuyuki NumakuraKazuyuki Numakura More articles by this author , Hiroshi TsurutaHiroshi Tsuruta More articles by this author , Atsushi MaenoAtsushi Maeno More articles by this author , Shigeru SatohShigeru Satoh More articles by this author , and Tomonori HabuchiTomonori Habuchi More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2049AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Adherent perinephric fat (APF) is a risk factor for surgical difficulty during partial nephrectomy. No previous report has analyzed pure host-related risk factors of APF among individuals without cancer. Here, we assessed risk factors and characteristics of APF in healthy individuals. METHODS Men who underwent laparoscopic donor nephrectomy between 2009 and 2014 were included in the present study. Based on retrospective review of video-recorded surgical procedures during anterior perinephric fat dissection, the severity of APF was categorized into the following three groups: non-APF (0), APF (1), and severe APF (2). The relationship between APF severity and clinical/radiographic features was evaluated. The relationship between cytokine expression in perinephric fat tissue (PAT)-conditioned medium and APF severity was also assessed using SearchLight Multiplex assays. RESULTS Of the 92 patients, 43 (46.7%) and 8 (8.7%) were categorized as having APF and severe APF, respectively. Mean operative duration was significantly associated with APF severity (trend, P = 0.00248), and patients with severe APF had a significantly higher estimated blood loss than those without (P = 0.002). No difference in postoperative serum creatinine levels or rates of delayed graft function in recipients was observed among the three groups. Gender, body mass index, perinephric fat area, stranding, and thickness were significantly associated with severe APF. On multivariate analysis, perinephric fat area (OR, 1.189; P = 0.005) and the presence of renal stranding (OR, 14.450; P = 0.037) were identified as independent risk factors for severe APF. Of the 44 analyzed cytokines, mean levels of sIL-6R in PAT-conditioned medium were found to be significantly higher in the APF groups than in the non-APF group (P = 0.049). In a validation study with a larger number of donors (n = 48), mean sIL-6R levels remained significantly higher in both groups with APF compared to the non-APF group (P = 0.042). CONCLUSIONS Several radiographic features, such as perinephric fat area and stranding, were found to be pure host-related risk factors for severe APF. sIL-6R secreted from adipose tissues may have utility in predicting the severity of APF in patients undergoing renal surgery. Pure host-related risk factors for APF may predict difficulty during perinephric fat dissection. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e876 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Shintaro Narita More articles by this author Takamitsu Inoue More articles by this author Mitsuru Saito More articles by this author Taketoshi Nara More articles by this author Koichiro Takayama More articles by this author Kazuyuki Numakura More articles by this author Hiroshi Tsuruta More articles by this author Atsushi Maeno More articles by this author Shigeru Satoh More articles by this author Tomonori Habuchi More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...