scholarly journals Analysis of Clinical Characteristics, Radiological Predictors, Pathological Features and Perioperative Outcomes Associated with Perinephric Fat Adhesion Degree

2021 ◽  
Author(s):  
Junqiang Liu ◽  
Hongwei Huang ◽  
Yiheng Jiang ◽  
Zheng Zhu ◽  
Jing Chen ◽  
...  

Abstract Background To assess the clinical characteristics, radiological predictors and pathological features of perinephric fat adhesion degree (PFAD) graded based on fixed criteria and to determine the impact of adherent perinephric fat (APF) on retroperitoneal laparoscopic partial nephrectomy (RLPN) outcomes. Methods 84 patients undergoing RLPN were included and graded into 4 groups based on PFAD. Univariate and multivariate analysis were performed for clinical characteristics and radiological predictors of PFAD. Perioperative data was compared between APF groups and non-APF groups. Masson staining determined collagen fibers. Immunohistochemistry detected CD45 immune cells and CD34 vessels. Results: 20, 28, 18 and 18 patients were graded as normal perinephric fat (NPF), mild adherent perinephric fat (MiPF), moderate adherent perinephric fat (MoPF) and severe adherent perinephric fat (SPF), respectively. Multivariate analysis revealed that gender (p < 0.001), age (p = 0.003) and hypertension (p = 0.006) were significant clinical risk factors of PFAD, while radiological predictors included perinephric stranding (p = 0.001), posterior perinephric fat thickness (p = 0.009) and perinephric fat density (p = 0.02). APF was associated with drain output (P = 0.012) and accompanied by immune cells gathering in renal cortex near thickened renal capsule with many vessels. Conclusions Clinical characteristics and radiological predictors can evaluate PFAD and may assist guide preoperative surgical option. Pathological features of APF reflect decapsulation and bleeding during kidney mobilization at RLPN.

2020 ◽  
Author(s):  
Junqiang Liu ◽  
Hongwei Huang ◽  
Tianyu Cao ◽  
Dikuan Liu ◽  
Zheng Zhu ◽  
...  

Abstract Background To assess the clinical characteristics, radiological predictors and pathological features of perinephric fat adhesion degree (PFAD) graded based on fixed criteria and to determine the impact of adherent perinephric fat (APF) on retroperitoneal laparoscopic partial nephrectomy (RLPN) outcomes. Methods 84 patients undergoing RLPN were included and graded into 4 groups based on PFAD. Univariate and multivariate analysis were performed for clinical characteristics and radiological predictors of PFAD. Perioperative data was compared between APF groups and non-APF groups. Masson staining determined collagen fibers. Immunohistochemistry detected CD45 immune cells and CD34 vessels. Results 20, 28, 18 and 18 patients were graded as normal perinephric fat (NPF), mild adherent perinephric fat (MiPF), moderate adherent perinephric fat (MoPF) and severe adherent perinephric fat (SPF), respectively. Multivariate analysis revealed that gender (p < 0.001), age (p = 0.003) and hypertension (p = 0.006) were significant clinical risk factors of PFAD, while radiological predictors included perinephric stranding (p = 0.001), posterior perinephric fat thickness (p = 0.009) and perinephric fat density (p = 0.02). APF was associated with drain output (P = 0.012) and accompanied by immune cells gathering in renal cortex near thickened renal capsule with many vessels. Conclusions Clinical characteristics and radiological predictors can evaluate PFAD and may assist guide preoperative surgical option. Pathological features of APF reflect decapsulation and bleeding during kidney mobilization at RLPN.


2021 ◽  
Author(s):  
Junqiang Liu ◽  
Hongwei Huang ◽  
Yiheng Jiang ◽  
Dikuan Liu ◽  
Zheng Zhu ◽  
...  

Abstract Background: To assess the clinical characteristics, radiological predictors and pathological features of perinephric fat adhesion degree (PFAD) graded based on fixed criteria and to determine the impact of adherent perinephric fat (APF) on retroperitoneal laparoscopic partial nephrectomy (RLPN) outcomes. Methods: 84 patients undergoing RLPN were included and graded into 4 groups based on PFAD. Univariate and multivariate analysis were performed for clinical characteristics and radiological predictors of PFAD. Perioperative data was compared between APF groups and non-APF groups. Masson staining determined collagen fibers. Immunohistochemistry detected CD45 immune cells and CD34 vessels.Results: 20, 28, 18 and 18 patients were graded as normal perinephric fat (NPF), mild adherent perinephric fat (MiPF), moderate adherent perinephric fat (MoPF) and severe adherent perinephric fat (SPF), respectively. Multivariate analysis revealed that gender (p<0.001), age (p=0.003) and hypertension (p=0.006) were significant clinical risk factors of PFAD, while radiological predictors included perinephric stranding (p=0.001), posterior perinephric fat thickness (p=0.009) and perinephric fat density (p=0.02). APF was associated with drain output (P = 0.012) and accompanied by immune cells gathering in renal cortex near thickened renal capsule with many vessels.Conclusions: Clinical characteristics and radiological predictors can evaluate PFAD and may assist guide preoperative surgical option. Pathological features of APF reflect decapsulation and bleeding during kidney mobilization at RLPN.


2020 ◽  
Author(s):  
Junqiang Liu ◽  
Hongwei Huang ◽  
Tianyu Cao ◽  
Dikuan Liu ◽  
Zheng Zhu ◽  
...  

Abstract Background To assess the clinical characteristics, radiological predictors and pathological features of perinephric fat adhesion degree (PFAD) graded based on fixed criteria and to determine the impact of adherent perinephric fat (APF) on retroperitoneal laparoscopic partial nephrectomy (RLPN) outcomes.Methods 84 patients undergoing RLPN were included and graded into 4 groups based on PFAD. Univariate and multivariate analysis were performed for clinical characteristics and radiological predictors of PFAD. Perioperative data was compared between APF groups and non-APF groups. Masson staining determined collagen fibers. Immunohistochemistry detected CD45 immune cells and CD34 vessels.Results 20, 28, 18 and 18 patients were graded as normal perinephric fat (NPF), mild adherent perinephric fat (MiPF), moderate adherent perinephric fat (MoPF) and severe adherent perinephric fat (SPF), respectively. Multivariate analysis revealed that gender (p<0.001), age (p=0.003) and hypertension (p=0.006) were significant clinical risk factors of PFAD, while radiological predictors included perinephric stranding (p=0.001), posterior perinephric fat thickness (p=0.009) and perinephric fat density (p=0.02). APF was associated with drain output (P = 0.012) and accompanied by immune cells gathering in renal cortex near thickened renal capsule with many vessels.Conclusions Clinical characteristics and radiological predictors can evaluate PFAD and may assist guide preoperative surgical option. Pathological features of APF reflect decapsulation and bleeding during kidney mobilization at RLPN.


2020 ◽  
Author(s):  
Junqiang Liu ◽  
Hongwei Huang ◽  
Tianyu Cao ◽  
Dikuan Liu ◽  
Zheng Zhu ◽  
...  

Abstract Background To assess the clinical characteristics, radiological predictors and pathological features of perinephric fat adhesion degree (PFAD) graded based on fixed criteria and to determine the impact of adherent perinephric fat (APF) on retroperitoneal laparoscopic partial nephrectomy (RLPN) outcomes. Methods 84 patients undergoing RLPN were included and graded into 4 groups based on PFAD. Univariate and multivariate analysis were performed for clinical characteristics and radiological predictors of PFAD. Perioperative data was compared between APF groups and non-APF groups. Masson staining determined collagen fibers. Immunohistochemistry detected CD45 immune cells and CD34 vessels. Results 20, 28, 18 and 18 patients were graded as normal perinephric fat (NPF), mild adherent perinephric fat (MiPF), moderate adherent perinephric fat (MoPF) and severe adherent perinephric fat (SPF), respectively. Multivariate analysis revealed that gender (p < 0.001), age (p = 0.003) and hypertension (p = 0.006) were significant clinical risk factors of PFAD, while radiological predictors included perinephric stranding (p = 0.001), posterior perinephric fat thickness (p = 0.009) and perinephric fat density (p = 0.02). APF was associated with drain output (P = 0.012) and accompanied by immune cells gathering in renal cortex near thickened renal capsule with many vessels. Conclusions Clinical characteristics and radiological predictors can evaluate PFAD and may assist guide preoperative surgical option. Pathological features of APF reflect decapsulation and bleeding during kidney mobilization at RLPN.


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Junqiang Liu ◽  
Yiheng Jiang ◽  
Hongwei Huang ◽  
Zheng Zhu ◽  
Jing Chen ◽  
...  

Background. To assess the clinical characteristics, radiological predictors, and pathological features of perinephric fat adhesion degree (PFAD) graded based on fixed criteria and to determine the impact of adherent perinephric fat (APF) on retroperitoneal laparoscopic partial nephrectomy (RLPN) outcomes. Methods. 84 patients undergoing RLPN were included and graded into 4 groups based on PFAD. Univariate and multivariate analyses were performed for clinical characteristics and radiological predictors of PFAD. Perioperative data were compared between APF groups and non-APF groups. Masson staining determined collagen fibers. Immunohistochemistry detected CD45 immune cells and CD34 vessels. Results. 20, 28, 18, and 18 patients were graded as normal perinephric fat (NPF), mild adherent perinephric fat (MiPF), moderate adherent perinephric fat (MoPF), and severe adherent perinephric fat (SPF), respectively. Multivariate analysis revealed that gender ( p  < 0.001), age ( p  = 0.003), and hypertension ( p  = 0.006) were significant clinical risk factors of PFAD, while radiological predictors included perinephric stranding ( p  = 0.001), posterior perinephric fat thickness ( p  = 0.009), and perinephric fat density ( p  = 0.02). APF was associated with drain output ( p  = 0.012) and accompanied by immune cells gathering in renal cortex near thickened renal capsule with many vessels. Conclusions. Clinical characteristics and radiological predictors can evaluate PFAD and may assist to guide preoperative surgical option. Pathological features of APF reflect decapsulation and bleeding during kidney mobilization at RLPN.


2008 ◽  
Vol 68 (9) ◽  
pp. 1474-1477 ◽  
Author(s):  
B Ranque ◽  
F-J Authier ◽  
V Le-Guern ◽  
C Pagnoux ◽  
A Berezne ◽  
...  

Objectives:To describe the clinical characteristics and muscle pathological features of patients with systemic sclerosis (SSc) and myopathy and analyse their impact on muscle outcome.Methods:Thirty-five patients with myopathy and available muscle biopsy were restrospectively investigated from the charts of four hospital centres.Results:Twenty-six (74%) cases had diffuse SSc. The median time from SSc diagnosis was 5 years (range 0–23) at myopathy onset. The main myopathological features were mononuclear inflammation (63%), muscle atrophy (60%), necrosis (59%), regeneration (44%), fibrosis (24%) or microangiopathy (27%). After a median follow-up of 4.4 years, 24 patients (69%) showed complete or partial muscle remission. Only histological muscle inflammation was associated with good muscle prognosis in multivariate analysis (odds ratio 44.7, 95% CI 2.8 to 704.7). Patients without muscle inflammation had a poor response to corticosteroids (38% favourable response vs 90% in patients with inflammation).Conclusion:Muscle histopathology is critical in the therapeutic management of SSc-associated myopathy.


BMC Urology ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Daisuke Motoyama ◽  
Yuto Matsushita ◽  
Hiromitsu Watanabe ◽  
Keita Tamura ◽  
Toshiki Ito ◽  
...  

Abstract 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.


2017 ◽  
Vol 11 (3-4) ◽  
pp. 131 ◽  
Author(s):  
Simon Ouellet ◽  
Robert Sabbagh ◽  
Claudio Jeldres

Introduction: We aimed to assess the effect of previous abdominal surgery on perioperative outcomes in patients undergoing transperitoneal laparoscopic partial (LPN) or radical (LRN) nephrectomy for renal masses.Methods: We retrospectively reviewed all cases of LPN and LRN for renal masses at our institution between 2008 and 2014. Patients were divided in two groups, those with and without prior abdominal surgery. Four perioperative outcomes were compared, namely, operative time (OT), estimated blood loss (EBL), length of stay (LOS), and 30-days complications rate. A subanalysis was performed to address the impact of previous open cholecystectomy on right LPN or LRN.Results: Of 293 patients identified, 146 (49.8%) had previous abdominal surgery. In univariate analysis, no differences in operative time (136 vs. 144 minutes; p=0.154), EBL (88 vs. 100 mL; p=0.211), or 30-day complication rate (24 vs. 14%; p=0.069) were recorded between the groups. Only LOS favoured patients without previous abdominal surgery (3 vs. 4 days; p=0.001). In multivariate analysis, prior abdominal surgery was not associated with an increased OT, EBL, LOS, or complication rate. The analysis of right nephrectomies showed increased OT (148 vs. 128 minutes; p=0.049) and complication rate (42 vs. 16%; p=0.004) for patients with past open cholecystectomy compared to those without. Multivariate analysis revealed that prior open cholecystectomy was associated with a longer LOS (ORmedian=2.7 [1.2‒8.0]) and an increased risk of complications (ORmedian=4.5 [1.6‒10.5]).Conclusions: In this cohort, previous abdominal surgery was not associated with worse perioperative outcomes after transperitoneal LPN and LRN for renal masses. However, previous open cholecystectomy resulted in a higher risk of complication and a longer LOS in patients undergoing right laparoscopic nephrectomy.


2020 ◽  
Vol 18 (7) ◽  
pp. 1397-1414
Author(s):  
K.S. Golondarev

Subject. This article explores the issues of business tourism clustering in Greater Moscow. Objectives. The article intends to justify the need to create a business tourism cluster in Greater Moscow to improve the investment climate in the region. Methods. For the study, I used a multivariate analysis, forecasting, and extrapolation. Results. The article shows a certain relationship between the efficient functioning of the business tourism cluster and the economy's development. Conclusions and Relevance. Certain types of tourist clusters can serve as platforms for attracting investors and implementing marketing plans. The business tourism cluster is a link between buyers and sellers in various industries. The results of the study can be used to improve the effectiveness of the cluster initiative in business tourism, as well as find ways of cooperation between the State and private investors when creating the business tourism cluster in Greater Moscow.


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