接受腹腔镜活体供肾肾切除术的健康个体中与肾周脂肪粘连相关的宿主危险因素。
Host-related Risk Factors for Adherent Perinephric Fat in Healthy Individuals Undergoing Laparoscopic Living-donor Nephrectomy.
作者信息
Narita Shintaro, Kumazawa Teruaki, Tsuchiya Norihiko, Mingguo Huang, Saito Mitsuru, Inoue Takamitsu, Tsuruta Hiroshi, Numakura Kazuyuki, Maeno Atsushi, Nanjo Hiroshi, Satoh Shigeru, Habuchi Tomonori
机构信息
*Department of Urology, Akita University School of Medicine ∥Department of Pathology, Akita University School of Medicine ¶Center for Kidney Disease and Transplantation, Akita University Hospital ‡Department of Urology, Omagari Kousei Medical Center, Akita §Department of Urology, Yamagata University School of Medicine, Yamagata †AMED-CREST, Japan Agency for Medical Research and Development (AMED), Tokyo, Japan.
出版信息
Surg Laparosc Endosc Percutan Tech. 2017 Aug;27(4):e69-e73. doi: 10.1097/SLE.0000000000000433.
PURPOSE
The purpose of this study is to assess the risk factors and characteristics of adherent perinephric fat (APF) in healthy individuals.
PATIENTS AND METHODS
Men who underwent laparoscopic donor nephrectomy were included. Video review was used to divide patients on the basis of APF severity. Relationship between APF scores and clinical and radiographic features was evaluated.
RESULTS
Of the 92 patients, 43 (46.7%) and 8 (8.7%) were categorized as APF and severe APF, respectively. The median total operative time was significantly associated with APF severity. Sex, body mass index, and perinephric fat area, stranding, and thickness were significantly associated with severe APF. In the multivariate analysis, perinephric fat areas and stranding were independent risk factors for severe APF (HR, 1.189 and 14.450, respectively). In the 44 analyzed cytokines, levels of sIL-6R in the perinephric adipose tissue-conditioned medium were significantly higher for APF group than that for non-APF group (P=0.049).
CONCLUSIONS
Host-related risk factors for APF could predict surgical difficulty in patients undergoing partial nephrectomy.
目的
本研究旨在评估健康个体中粘连性肾周脂肪（APF）的危险因素及特征。
患者与方法
纳入接受腹腔镜供肾切除术的男性患者。通过视频回顾根据APF严重程度对患者进行分组。评估APF评分与临床及影像学特征之间的关系。
结果
92例患者中，分别有43例（46.7%）和8例（8.7%）被归类为APF和重度APF。总手术时间中位数与APF严重程度显著相关。性别、体重指数、肾周脂肪面积、条索状改变及厚度与重度APF显著相关。多因素分析中，肾周脂肪面积和条索状改变是重度APF的独立危险因素（风险比分别为1.189和14.450）。在分析的44种细胞因子中，APF组肾周脂肪组织条件培养基中sIL-6R水平显著高于非APF组（P = 0.049）。
结论
APF的宿主相关危险因素可预测接受部分肾切除术患者的手术难度。
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