PD16-06 NOT ALL FAT WEIGHS THE SAME: VISCERAL FAT AND PARTIAL NEPHRECTOMY PERIOPERATIVE OUTCOMES

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy II (PD16)1 Sep 2021PD16-06 NOT ALL FAT WEIGHS THE SAME: VISCERAL FAT AND PARTIAL NEPHRECTOMY PERIOPERATIVE OUTCOMES Dora Jericevic, James Wysock, Samir Taneja, and William Huang Dora JericevicDora Jericevic More articles by this author , James WysockJames Wysock More articles by this author , Samir TanejaSamir Taneja More articles by this author , and William HuangWilliam Huang More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001998.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Visceral fat (VF) and adherent perinephric fat (APF) have been linked to worse perioperative outcomes during robotic partial nephrectomy (RAPN). Since body mass index (BMI) does not distinguish between VF and subcutaneous fat (SF), alternative fat measures such as the Mayo Adhesive Probability (MAP) Score have been developed. With advanced imaging software, some investigators have proposed quantifying the VF encountered during PN. The objectives of this prospective study were to compare fat measures and assess their impact on perioperative outcomes. METHODS: With IRB approval, between August 2018 and March 2020, patients undergoing RAPN were consented for the study. Intraoperatively, the surgeon assessed APF. Independent analysis of preoperative imaging was using to calculate MAP Score and quantify VF and SF using TeraRecon. Our patient population was studied as 2 groups: those with (+) and without (-) APF. We further assessed the relationship between visceral obesity and perioperative outcomes. RESULTS: Of the 139 patients that underwent a RAPN and consented for the study, 47 (34%) had APF (+APF). The +APF patients were predominantly older males with multiple medical comorbidities (table 1). There was no statistically significant difference in BMI between the +APF and -APF groups (29 vs 27 kg/m2), but the +APF group had more VF. All fat measures except for BMI were highly correlated (ρ>0.7). +APF patients had higher EBL and longer operative times (p<0.01), but higher complication and malignancy rates were not observed. On logistic linear regression analysis, only APF and RENAL score remained predictors of prolonged operative time. On ROC analysis, at the optimal threshold of MAP≥4 to predict APF, a sensitivity of 0.81 and specificity of 0.78 was observed in our cohort. CONCLUSIONS: Alternatives to BMI that distinguish SF from VF capture patient-specific fat factors that complicate PN. They are a valuable addition to nephrometry scores centered entirely on tumor-specific factors and should be considered in preoperative counseling and surgical planning. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e280-e281 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Dora Jericevic More articles by this author James Wysock More articles by this author Samir Taneja More articles by this author William Huang More articles by this author Expand All Advertisement Loading ...