The impact of gender difference on operative time in laparoscopic partial nephrectomy for T1 renal tumor and the utility of retroperitoneal fat thickness as a predictor of operative time

Ito, Hiroki; Makiyama, Kazuhide; Kawahara, Takashi; Osaka, Kimito; Izumi, Kiyotaka; Yokomizo, Yumiko; Nakaigawa, Noboru; Yao, Masahiro

doi:10.1186/s12885-016-2979-5

Cited by 12 publications

(10 citation statements)

References 29 publications

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“…Further, our observation that operative time was also affected by the sex of the patients and the experience of surgeon concurs with results from previous reports. 22,23 On the other hand, there were no differences in the success rate of PTx between the RCMT and NCMT groups in the present study, probably because the anatomy of the parathyroid glands themselves, unlike the range or difficulty of dissection of parathyroid gland, was not affected by enlargement or pathological changes after treatment with calcimimetics. Conversely, enlargement of the parathyroid glands may even facilitate their detection during PTx.…”

Section: Discussioncontrasting

confidence: 60%

Surgical outcomes of parathyroidectomy for secondary hyperparathyroidism resistant to calcimimetic treatment: A retrospective single‐center cohort study

et al. 2020

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To evaluate the surgical outcomes of parathyroidectomy (PTx) for secondary hyperparathyroidism (SHPT) resistant to calcimimetic treatment, we retrospectively studied 187 patients with SHPT who had no history of calcimimetic treatment (NCMT) (NCMT group) and 186 patients with SHPT who were resistant to calcimimetic treatment (RCMT) (RCMT group). Success rate and operative time of PTx were compared among the two groups. Operative time was significantly longer in the RCMT group than in the NCMT group (180 vs 158 minutes, P < .001), but the difference was attenuated after multivariate adjustment including the weight of the largest parathyroid gland. No significant differences were observed in success rate of PTx (90.9% vs 91.4%, P = 1.000) between the two groups. In patients with SHPT who are resistant to calcimimetic treatment, operative time could be elongated but success rate of PTx remains unchanged.

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Section: Discussioncontrasting

confidence: 60%

Surgical outcomes of parathyroidectomy for secondary hyperparathyroidism resistant to calcimimetic treatment: A retrospective single‐center cohort study

et al. 2020

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“…A recent retrospective study by Ito et al on 111 RCCs cT1aN0M0 [38] showed that males had a higher retroperitoneal fat tissue thickness (determined by computed tomography scan) than females, and that, as a consequence, the operative time during retroperitoneal laparoscopic NSS was significantly longer in male patients than in female patients (181.8 ± 34.9 min in males, 150.7 ± 24.7 min in females; p < 0.001). Overall, the operative time of retroperitoneal laparoscopic NSS was significantly correlated not only with gender, but also with maximum tumor diameter, and retroperitoneal fat tissue thickness.…”

Section: Surgery and Surgical Outcomesmentioning

confidence: 97%

Gender-Related Approach to Kidney Cancer Management: Moving Forward

Mancini

Righetto

Baggio

2020

IJMS

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Men are more frequently diagnosed with kidney cancer than women, with a more aggressive histology, larger tumors, a higher grade and stage, and worse oncological outcomes. Smoking habits and sex steroid hormones seem to have a possible role in explaining these gender disparities. Moreover, the expression of genes involved in tumor growth and immune response in kidney cancer varies between men and women, having an impact on the gender-related response to oncological therapy, such as anti-angiogenic drugs and immunotherapy. Recent advances have been made in our understanding of the molecular and genetic mechanisms involved in kidney cancer, which could partially explain the gender differences, and they are summarized in this paper. However, other key mechanisms, which fully clarify the striking clinical gender-related differences observed in kidney cancer, are not completely understood at present. We reviewed and summarized the most relevant publications about the relationship between gender and kidney cancer. Efforts should be made to progress in bench and clinical research on gender-related signatures and disparities, and their impact on the clinical management of kidney cancer.

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“…Retroperitoneal fat thickness is reported to affect duration of surgery, as it did in the present study. In addition to male gender, Ito et al showed that retroperitoneal fat thickness is positively correlated with surgical duration 3 . In a prospective study of 100 robotic partial nephrectomies it was reported that surgery time in patients with APF was longer than in those without APF 12 .…”

Section: Discussionmentioning

confidence: 99%

“…Patient-related factors, including gender, and visceral and perinephric fat thickness are clinically associated with the complexity of surgery and surgical outcome 1,3 . For predicting the complexity of perirenal fat dissection many researchers suggest using such tools as renal scoring systems and pre-operative computed tomography (CT) measurement 4,5 .…”

Section: Introductionmentioning

confidence: 99%

Pathology Associated with Adherent Perirenal Fat and its Clinical Effect

Ceyhan

Ileri

Aki

et al. 2021

Preprint

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Introduction The dissection of perirenal fat is of critical importance to kidney surgery and ease of dissection is more important when using minimally invasive approaches. This study aimed to determine the clinical, radiological, and pathological significance of adherent perirenal fat(APF). Materials and Methods This prospective study included 22 patients scheduled for partial nephrectomy and 40 patients for donor nephrectomy. Intra-operative fat dissection time was recorded and the complexity of perirenal fat dissection was surgeon-classified as easy, moderate, and difficult. Perirenal fat and subcutaneous fat thickness was measured. Measurement of perirenal fat depth, and the Hounsfield unit(HU) for both perirenal and subcutaneous fields was performed using CT images. All specimens were submitted for histopatological analysis. Researchers in each arm were blinded to other researchers’ data. Results Mean age of the patients was 51.3±12.7years. Mean perirenal fat dissection time was 15.0±13.5min. Patient demographics, BMI, nor occupational status differed between the 3 complexity of perirenal fat dissection groups. Radiological findings showed that there was a significant correlation between perirenal fat depth and complexity of perirenal fat dissection(p<0.05), but not with HU measurements or subcutaneous fat thickness. Surgeon classification of the complexity of perirenal fat dissection was in accordance with the duration of dissection(p<0.05). Perinephric fat contained more fibrous tissue in the patients with histologically proven APF than in those without(p<0.05). Conclusions APF is a challenge during kidney surgery. Difficult dissection prolongs the duration of surgery, which can lead to complications. Perirenal fat thickness measured via pre-operative CT might be used to predict APF.

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The impact of gender difference on operative time in laparoscopic partial nephrectomy for T1 renal tumor and the utility of retroperitoneal fat thickness as a predictor of operative time

Cited by 12 publications

References 29 publications

Surgical outcomes of parathyroidectomy for secondary hyperparathyroidism resistant to calcimimetic treatment: A retrospective single‐center cohort study

Surgical outcomes of parathyroidectomy for secondary hyperparathyroidism resistant to calcimimetic treatment: A retrospective single‐center cohort study

Gender-Related Approach to Kidney Cancer Management: Moving Forward

Pathology Associated with Adherent Perirenal Fat and its Clinical Effect

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