后腹腔镜肾部分切除术前肾周脂肪粘连的评估

Evaluation of adherent perirenal fat before retroperitoneal laparoscopic partial nephrectomy

目的探讨后腹腔镜肾部分切除术术前肾周脂肪粘连的评估方法。方法抽取2015年11月至2018年11月于潍坊市人民医院行后腹腔镜肾部分切除术141例肾癌患者,其中肾周脂肪粘连者50例,非肾周脂肪粘连者91例。回顾性分析肾癌患者肾周脂肪粘连的影响因素。结果141例肾癌患者肾周脂肪粘连的发生率为35.3%(50/141),其中梅奥粘连风险(MAP)评分4分者占71.8%(28/39),5分者占82.4%(14/17)。肾周脂肪粘连者年龄、糖尿病、高血压、吸烟史、肿瘤长径与非肾周脂肪粘连者比较差异未见统计学意义(P>0.05);男性、高体质指数、高MAP评分是肾周脂肪粘连的影响因素(P<0.05)。结论MAP评分高的肥胖男性肾癌患者更易出现肾周脂肪粘连,MAP评分可用于肾癌患者行后腹腔镜肾部分切除术前评估肾周脂肪粘连情况。

Objective To investigate the evaluation of adherent perirenal fat(APF)before retroperitoneal laparoscopic partial nephrectomy.Methods A total of 141 patients with renal carcinoma who underwent retroperitoneal laparoscopic nephrectomy from November 2015 to November 2018 in Weifang People’s Hospital were selected.Among them,50 cases had APF,and 91 cases had non-APF.The influencing factors of APF in patients with renal carcinoma were retrospectively analyzed.Results The incidence of APF in 141 patients with renal carcinoma was 35.3%(50/141),of which Mayo adhesive probability(MAP)score 4 points accounted for 71.8%(28/39),5 points accounted for 82.4%(14/17).The age,diabetes,hypertension,smoking history,and tumor major diameter of patients with APF had no significant difference in comparison with those of patients with non-APF,(P>0.05);male,high body mass index,and high MAP score were the influencing factors of APF(P<0.05).Conclusions Fat males with high MAP score were susceptible to APF.MAP score can be used to predict APF before retroperitoneal laparoscopic partial nephrectomy.