Journal
JOURNAL OF ROBOTIC SURGERY
Volume 17, Issue 4, Pages 1485-1491Publisher
SPRINGERNATURE
DOI: 10.1007/s11701-023-01544-8
Keywords
Renal cell cancer; Robot-assisted partial nephrectomy; Perinephric fat volume; MAP score; Time to clamping
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This study aimed to evaluate the association between perinephric fat volume (PNFV) and Mayo Adhesive Probability (MAP) score with time to clamping (TTC) in robot-assisted partial nephrectomy (RAPN). The results showed that both PNFV and MAP score were significantly correlated with TTC and were identified as independent factors for prolonged TTC in multivariate analysis.
The aim of this study is to evaluate the association of perinephric fat volume (PNFV) and the Mayo Adhesive Probability (MAP) score with time to clamping (TTC) in robot-assisted partial nephrectomy (RAPN). The study subjects consisted of 73 tumors in 72 patients who underwent transperitoneal RAPN at a single cancer center between February 2020 and July 2022. Clinical characteristics including R.E.N.A.L. nephrometry score, MAP score and PNFV were evaluated in a multivariate analysis in relation to TTC, which was classified into two groups based on median TTC. PNFV and MAP score were analyzed separately. PNFVs were measured by SYNAPSE VINCENT (R) by a single expert urologist. Median TTC was 67 (range: 36-119) min. Spearman's rank correlation analysis indicated that a significant correlation was observed between PNFV and MAP score with a value of 0.81 (p < 0.0001). Univariate analysis revealed that R.E.N.A.L. nephrometry score >= 7 (p = 0.036), posterior tumor location (p = 0.033), MAP score >= 3 (p = 0.02) and PNFV >= 250 ml (p = 0.02) were significant factors for prolonged TTC. In a multivariate analysis including PNFV (analysis 1), R.E.N.A.L. nephrometry score >= 7 (OR 3.54, p = 0.018) and PNFV >= 250cm(3) (OR 3.94, p = 0.010) were independent factors for prolonged TTC. Similarly for MAP score (analysis 2), R.E.N.A.L. nephrometry score >= 7 (OR 3.54, p = 0.018) and MAP score >= 3 (OR 3.94, p = 0.010) were independent factors for prolonged TTC. Both MAP score and PNFV may have a significant impact on TTC.
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