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Pathology Associated with Adherent Perirenal Fat and its Clinical Effect
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  • Erman Ceyhan,
  • Fatih Ileri,
  • Fazıl Tuncay Aki,
  • Mustafa Sertac Yazici,
  • Musturay Karcaaltincaba,
  • Dilek Ertoy Baydar,
  • Cenk Yucel Bilen
Erman Ceyhan
Hacettepe University Faculty of Medicine
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Fatih Ileri
Hacettepe University Faculty of Medicine
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Fazıl Tuncay Aki
Hacettepe University Faculty of Medicine
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Mustafa Sertac Yazici
Hacettepe University Faculty of Medicine
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Musturay Karcaaltincaba
Hacettepe University Faculty of Medicine
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Dilek Ertoy Baydar
Koc Universitesi
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Cenk Yucel Bilen
Hacettepe University Faculty of Medicine
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Abstract

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.

Peer review status:ACCEPTED

28 Feb 2021Submitted to International Journal of Clinical Practice
02 Mar 2021Submission Checks Completed
02 Mar 2021Assigned to Editor
03 Mar 2021Reviewer(s) Assigned
22 May 2021Review(s) Completed, Editorial Evaluation Pending
07 Jun 20211st Revision Received
09 Jun 2021Submission Checks Completed
09 Jun 2021Assigned to Editor
09 Jun 2021Review(s) Completed, Editorial Evaluation Pending
11 Jun 2021Editorial Decision: Accept