演題抄録

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開催概要
開催回
第56回・2018年・横浜
 

術前CTの腎周囲脂肪の線維化所見は腎部分切除術における腎周囲脂肪の癒着を予測し得る

演題番号 : P33-2

[筆頭演者]
演者)朝倉 寿久:1 
[共同演者]
岡 利樹:1、奥田 洋平:1、波多野 浩士:1、中井 康友:1、中山 雅志:1、垣本 健一:1、西村 和郎:1

1:大阪国際がんセンター・泌尿器科

 

Objective
The potential difficulty of partial nephrectomy (PN) can be anticipated by morphometric tumor-based scores such as RENAL score and PADUA classification. However, patient-related issues such as adherent perinephric fat (APF) also make PN difficult. The objective of this study is to assess the predictive factors of APF during PN.

Materials and methods
Seventy-five patients who underwent robotic-assisted partial nephrectomy (RAPN) from January 2016 to February 2018 in our institution were reviewed retrospectively. Perinephric stranding on preoperative CT imaging was assessed to predict APF. Preoperative variables such as age, sex, body mass index (BMI), perinephric stranding, and tumor diameter were evaluated for the prediction of APF using the logistic regression analysis.

Results
Eleven male patients (14.6%) had APF. In univariate analysis, age(OR=1.07,95%CI 1.01-1.06,P=0.01),sex(OR=2.54×108,95%CI2.41-N/A,P=0.0048),BMI(OR=1.25,95%CI 1.01-1.60,P=0.03),perinephric stranding,(OR=11.6,95%CI 2.77-53.2,P=0.0009)were significantly associated with APF. In multivariate analysis, perinephric stranding(OR=8.93,95%CI1.46-68.4,P=0.01)and sex(OR=8.67×108,95%CI1.84-N/A,P=0.01)were significant predictors of APF.

Conclusions
Perinephric stranding on preoperative CT imaging was a predictor of APF. Care should be taken for APF when performing RAPN for male patients with perinephric stranding.

キーワード

臓器別:腎・尿路・膀胱

手法別:手術療法

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