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.