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Significant impact of three-dimensional volumetry of perinephric fat on the console time during robot-assisted partial nephrectomy.
BMC Urology ( IF 1.7 ) Pub Date : 2019-12-12 , DOI: 10.1186/s12894-019-0567-0
Daisuke Motoyama 1 , Yuto Matsushita 1 , Hiromitsu Watanabe 1 , Keita Tamura 1 , Toshiki Ito 1 , Takayuki Sugiyama 1 , Atsushi Otsuka 1 , Hideaki Miyake 1
Affiliation  

BACKGROUND To assess the impact of volumetry of perinephric fat (PNF) on the perioperative outcomes of robot-assisted partial nephrectomy (RAPN). METHODS Between 2016 and 2019, a single surgeon performed RAPN for 128 patients with clinical T1a-b renal tumors at our institution, and the 70 most recent patients were included in this study to minimize the effects of surgical experience. PNF was defined as a fatty area around the kidney within the anatomical structures, including the lateroconal fascia, fusion fascia, psoas muscle, lumbar quadrate muscle and diaphragm, and its volume was calculated based on reconstructed three-dimensional computed tomography images using the SYNAPSE VINCENT system. RESULTS In this series, the trifecta and MIC (margin, ischemia and complications) score system outcomes were achieved in 69 (98.6%) and 64 patients (91.4%), respectively. The median PNF volume in the 70 patients was 166.05 cm3, which was significantly correlated with both the body mass index (BMI) and Mayo adhesive probability (MAP) score (correlation coefficient = 0.68 and 0.74, respectively). There was no significant difference in the R.E.N.A.L. nephrometry score, PNF volume or console time during RAPN among 5 groups consisting of 14 consecutive patients. Of several factors examined, the console time was significantly affected by the sex, MAP score and PNF volume, and only the PNF volume was independently associated with the console time. CONCLUSION Even if performed by an experienced robotic surgeon beyond the initial learning curve, the PNF volume may influence the console time during RAPN.

中文翻译:

机器人辅助部分肾切除术中,会阴部脂肪的三维容积对控制台时间的重大影响。

背景技术为了评估容积性会阴脂肪(PNF)对机器人辅助部分肾切除术(RAPN)围手术期结局的影响。方法在2016年至2019年之间,我们机构对128名患有T1a-b临床肾肿瘤的患者进行了一次单次手术,本研究纳入了70名最新患者,以最大程度地减少手术经验的影响。PNF定义为解剖结构中肾脏周围的脂肪区域,包括后圆锥筋膜,融合筋膜,腰大肌,腰方形肌和and肌,并使用SYNAPSE VINCENT根据重建的三维计算机断层扫描图像计算其体积系统。结果在本系列中,三联和MIC(边缘,局部缺血和并发症)评分系统的结果在69例(98.6%)和64例患者(91例)中获得了。4%)。70名患者的PNF体积中位数为166.05 cm3,与体重指数(BMI)和梅奥黏附概率(MAP)评分均显着相关(相关系数分别为0.68和0.74)。在由14例连续患者组成的5个组中,在RAPN期间RENAL肾功能评分,PNF量或安慰时间没有显着差异。在检查的几个因素中,性别,MAP评分和PNF量显着影响了控制台时间,只有PNF量与控制台时间独立相关。结论即使由经验丰富的机器人外科医生执行超出初始学习曲线的操作,PNF的体积也可能会影响RAPN期间的控制台时间。与体重指数(BMI)和梅奥黏附概率(MAP)得分均显着相关(相关系数分别为0.68和0.74)。在由14例连续患者组成的5个组中,在RAPN期间RENAL肾功能评分,PNF量或安慰剂时间无显着差异。在检查的几个因素中,控制台时间受性别,MAP得分和PNF量的显着影响,只有PNF量与控制台时间独立相关。结论即使由经验丰富的机器人外科医生进行超出初始学习曲线的操作,PNF的体积也可能会影响RAPN期间的控制台时间。与体重指数(BMI)和梅奥黏附概率(MAP)得分均显着相关(相关系数分别为0.68和0.74)。在由14例连续患者组成的5个组中,在RAPN期间RENAL肾功能评分,PNF量或安慰剂时间无显着差异。在检查的几个因素中,性别,MAP评分和PNF量显着影响了控制台时间,只有PNF量与控制台时间独立相关。结论即使由经验丰富的机器人外科医生进行超出初始学习曲线的操作,PNF的体积也可能会影响RAPN期间的控制台时间。在由14例连续患者组成的5个组中,在RAPN期间RENAL肾功能评分,PNF量或安慰时间没有显着差异。在检查的几个因素中,性别,MAP评分和PNF量显着影响了控制台时间,只有PNF量与控制台时间独立相关。结论即使由经验丰富的机器人外科医生进行超出初始学习曲线的操作,PNF的体积也可能会影响RAPN期间的控制台时间。在由14例连续患者组成的5个组中,在RAPN期间RENAL肾功能评分,PNF量或安慰时间没有显着差异。在检查的几个因素中,性别,MAP评分和PNF量显着影响了控制台时间,只有PNF量与控制台时间独立相关。结论即使由经验丰富的机器人外科医生进行超出初始学习曲线的操作,PNF的体积也可能会影响RAPN期间的控制台时间。
更新日期:2020-04-22
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