Department of Urology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa-shi, Chiba, 277-8577, Japan.
J Robot Surg. 2023 Aug;17(4):1485-1491. doi: 10.1007/s11701-023-01544-8. Epub 2023 Feb 15.
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 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 (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.
本研究旨在评估肾周脂肪体积（PNFV）和梅奥粘连概率（MAP）评分与机器人辅助部分肾切除术（RAPN）中夹闭时间（TTC）的相关性。研究对象为 2020 年 2 月至 2022 年 7 月在一家癌症中心接受经腹腔 RAPN 的 72 例患者的 73 个肿瘤。在多变量分析中，评估了 R.E.N.A.L. 肾脏测量评分、MAP 评分和 PNFV 等临床特征与 TTC 的关系，TTC 根据中位数 TTC 分为两组。单独分析了 PNFV 和 MAP 评分。PNFV 由单一泌尿科专家使用 SYNAPSE VINCENT 进行测量。中位 TTC 为 67（范围：36-119）min。Spearman 等级相关分析表明，PNFV 与 MAP 评分之间存在显著相关性，相关系数为 0.81（p<0.0001）。单因素分析显示，R.E.N.A.L. 肾脏测量评分≥7（p=0.036）、肿瘤位于后位（p=0.033）、MAP 评分≥3（p=0.02）和 PNFV≥250ml（p=0.02）是 TTC 延长的显著因素。在包括 PNFV（分析 1）的多变量分析中，R.E.N.A.L. 肾脏测量评分≥7（OR 3.54，p=0.018）和 PNFV≥250cm（OR 3.94，p=0.010）是 TTC 延长的独立因素。对于 MAP 评分（分析 2）也是如此，R.E.N.A.L. 肾脏测量评分≥7（OR 3.54，p=0.018）和 MAP 评分≥3（OR 3.94，p=0.010）是 TTC 延长的独立因素。MAP 评分和 PNFV 都可能对 TTC 有显著影响。
