Effects of perirenal fat thickness on postoperative renal dysfunction in patients who underwent robot-assisted partial nephrectomy for renal tumours

Int J Med Robot. 2024 Aug;20(4):e2662. doi: 10.1002/rcs.2662.

Abstract

Background: Despite partial nephrectomy (PN) renal function preservation benefits, postoperative renal dysfunction may occur. Perirenal fat thickness (PFT) is associated with renal dysfunction such as diabetes; however, its role in renal tumour surgery is unclear. This study investigates the role of PFT in renal function after robot-assisted partial nephrectomy (RAPN).

Methods: Pre-operative factors for postoperative renal dysfunction were analysed in 156 patients undergoing RAPN with ≥1-year follow-up. PFT measured using computed tomography categorised patients with PFT >21.0 mm (median) as high-PFT.

Results: Tumour size, total R.E.N.A.L. nephrometry score and its N component, renal calyx opening, achievement of trifecta, and PFT were risk factors for renal dysfunction 1 year postoperatively. Age ≥75 years (p = 0.024), total RNS ≥7 (p = 0.036), and PFT >21.0 mm (p = 0.002) significantly correlated with postoperative renal dysfunction.

Conclusions: CT-measured PFT is a valuable predictor of postoperative renal dysfunction.

Keywords: partial nephrectomy; perirenal fat thickness; renal cell carcinoma; renal dysfunction; robot‐assisted surgery.

MeSH terms

  • Adipose Tissue* / diagnostic imaging
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Kidney Neoplasms* / surgery
  • Kidney* / diagnostic imaging
  • Kidney* / physiopathology
  • Kidney* / surgery
  • Male
  • Middle Aged
  • Nephrectomy* / adverse effects
  • Nephrectomy* / methods
  • Postoperative Complications* / etiology
  • Postoperative Period
  • Retrospective Studies
  • Risk Factors
  • Robotic Surgical Procedures* / methods
  • Tomography, X-Ray Computed*