Association Between Various Indices of Obesity and Intraoperative Factors in Laparoscopic Donor Nephrectomy

Kumazawa, Teruaki; Tsuchiya, Norihiko; Inoue, Takamitsu; Obara, Takashi; Saito, Mitsuru; Narita, Shintaro; Horikawa, Youhei; Satoh, Shigeru; Habuchi, Tomonori

doi:10.1089/lap.2011.0472

Cited by 13 publications

(7 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The methods for measuring the visceral fat and perinephric fat area have previously been described. 6 The thickness and area of fat were measured using a Synapse Vincent volume image analyzer system (Fujifilm, Tokyo, Japan). The presence of perinephric stranding, which was defined as a linear area of soft tissue attenuation in the perinephric space, 2 was also assessed by CT.…”

Section: Methodsmentioning

confidence: 99%

Host-related Risk Factors for Adherent Perinephric Fat in Healthy Individuals Undergoing Laparoscopic Living-donor Nephrectomy

Narita

Kumazawa

Tsuchiya

et al. 2017

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Methodsmentioning

confidence: 99%

Host-related Risk Factors for Adherent Perinephric Fat in Healthy Individuals Undergoing Laparoscopic Living-donor Nephrectomy

Narita

Kumazawa

Tsuchiya

et al. 2017

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

Self Cite

View full text Add to dashboard Cite

show abstract

“…As shown in Fig. , perinephric fat was measured on a contrast enhanced CT image at the level of the renal hilum on the ipsilateral side of the kidney harbouring the suspected renal tumour . The CT image of the slice of interest in Digital Imaging and Communications in Medicine (DICOM) format was then loaded into ImageJ software version 1.47f (Research Services Branch, National Institute of Mental Health, Bethesda, MD, USA).…”

Section: Methodsmentioning

confidence: 99%

Predicting ease of perinephric fat dissection at time of open partial nephrectomy using preoperative fat density characteristics

et al. 2014

View full text Add to dashboard Cite

ObjectiveTo predict the ease of perinephric fat surgical dissection at the time of open partial nephrectomy (OPN) using perinepheric fat density characteristics as measured on preoperative computed tomography (CT). Patients and MethodsIn all, 41 consecutive OPN patients with available preoperative imaging and prospectively collected dissection difficulty assessment were identified. Using a scoring system that was adopted for the purposes of this study, the genitourinary surgeon quantified the difficulty of the perinephric fat dissection on the surface of the renal capsule at the time of surgery. On axial CT slice centred on the renal hilum, we measured the quantity and density of perinephric fat whose absorption coefficient was between -190 to -30 Hounsfield units. Correlation between perinephric fat surface density (PnFSD) as noted on preoperative imaging and as observed by the surgeon at time of surgery were correlated in a completely 'double-blinded' fashion. Density comparisons between fat dissection difficulties were made using an ANOVA. Associations between covariates and perinephric fat density were evaluated by univariate and multivariate logistic regression analyses. Receiver-operating characteristic (ROC) curves for six different predictive models were created to visualise the predictive enhancement of PnFSD. ResultsPnFSD was positively correlated with total surgical duration (Pearson's correlation coefficient 0.314, P = 0.04). PnFSD significantly correlated with gender (P = 0.001) and difficulty of perinephric fat surgical dissection (P < 0.001) scores. The mean (SD) PnFSD for a dissection that was not difficult (n = 19) was 5598.32 (1367.77) surface density pixel unit (SDPU), and for a difficult dissection (n = 22) was 10272.23 (3804.67) SDPU. Univariate analysis showed gender (P = 0.002), and PnFSD were predictive of the presence of 'sticky' perinephric fat. A multivariate analysis model showed that PnFSD was the only variable that remained an independent predictor of perinephric fat dissection difficulty (P = 0.01). Of the six ROC models assessed, only PnFSD had a significant capability to predict the difficulty of the perinephric fat dissection due to the presence of highly adherent 'sticky' fat, with an area under the curve of 0.87 (P < 0.001). ConclusionAccurate preoperative assessment of perinephric fat density constitutes a strong indicator of perioperative fat dissection difficulty. Perinephric fat densities can be practically obtained from preoperative CT to identify 'sticky' fat, which may help determine the anticipated ease of surgical dissection, which can guide education, preoperative surgical planning, and potentially the surgical approach offered to patients.

show abstract

“…Kumazawa et al ., in their study, retrospectively investigated the association of various obesity indices and intraoperative factors in (transperitoneal or retroperitoneal) laparoscopic donor nephrectomy. [ 13 ] Perirenal fat area measured using CT scan imaging, influences operating time and EBL in retroperitoneal approach but not in transperitoneal approach. In a similar study by Akaihata et al ., anterior perirenal fat distance showed a significant association with operative difficulty during retroperitoneal laparoscopic radical nephrectomy, on both univariate and multivariate analysis.…”

Section: Discussionmentioning

confidence: 99%

Can preoperative clinicoradiological parameters predict the difficulty during laparoscopic retroperitoneal simple nephrectomy? – A prospective study

et al. 2018

View full text Add to dashboard Cite

Introduction:Urologists tend to prefer retroperitoneal approach for open nephrectomy and transperitoneal route for laparoscopic nephrectomy. Urologists consider retroperitoneal laparoscopic approach difficult to learn and perform. There is a need to objectively define predictors of difficulty during laparoscopic retroperitoneal simple nephrectomy (LRSN) for the proper preoperative selection. To the best of our knowledge, this is the first study to prospectively assess the factors associated with difficulty during LRSN.Materials and Methods:All adult patients of nonfunctioning kidneys (due to benign causes) planned for simple nephrectomies from November 2014 to January 2017 were included in the study. Various clinical and radiological parameters were noted along with intraoperative difficulty parameters (difficulty score, total operative time, and estimated blood loss). Renal and perirenal parameters were assessed and noted on computed tomography scan. Difficulty scale was calculated based on the three difficulty parameters and was used to objectively categorize the patients in easy and difficult group.Results:A total of 44 patients were included in the study. There were 23 patients in Group I (Easy) and 21 patients in Group II (Difficult). Various preoperative clinical and radiological parameters were analyzed and compared between these two groups. History of pyonephrosis and presence of nephrostomy tube were the only two statistically significant factors associated with difficult cases (Group II). None of the factors were statistically significant in multivariate analysis.Conclusion:Based on the findings of our study, history of pyonephrosis and presence of nephrostomy are the most significant factors predicting difficulty during LRSN.

show abstract

Association Between Various Indices of Obesity and Intraoperative Factors in Laparoscopic Donor Nephrectomy

Cited by 13 publications

References 19 publications

Host-related Risk Factors for Adherent Perinephric Fat in Healthy Individuals Undergoing Laparoscopic Living-donor Nephrectomy

Host-related Risk Factors for Adherent Perinephric Fat in Healthy Individuals Undergoing Laparoscopic Living-donor Nephrectomy

Predicting ease of perinephric fat dissection at time of open partial nephrectomy using preoperative fat density characteristics

Can preoperative clinicoradiological parameters predict the difficulty during laparoscopic retroperitoneal simple nephrectomy? – A prospective study

Contact Info

Product

Resources

About