Abstract
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 clam** (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® 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 ≥ 250cm3 (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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Data availability
The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.
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YN: study conception, data acquisition, data analysis, drafting the manuscript, statistical analysis, and obtaining funding. KH, RY, YU, NO and MK: data acquisition and data analysis. SY: data acquisition, data analysis and critical revision. HM: concept and design, data analysis, drafting the manuscript, critical revision and supervision. All authors read and approved the final manuscript.
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Nakanishi, Y., Hirose, K., Yasujima, R. et al. Impact of perinephric fat volume and the Mayo Adhesive Probability score on time to clam** in robot-assisted partial nephrectomy. J Robotic Surg 17, 1485–1491 (2023). https://doi.org/10.1007/s11701-023-01544-8
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DOI: https://doi.org/10.1007/s11701-023-01544-8