ABSTRACT
Objective To investigate the preliminary experience of laparoscopic partial nephrectomy in patients with adherent perinephric fat. Methods We retrospectively analyzed the clinical data of 16 patients with adherent perinephric fat undergoing laparoscopic partial nephrectomy by the single surgeon in the Department of Urology of Changhai Hospital, Second Military Medical University between Jan. 2016 and Dec. 2016. For the patients with serious adherent perinephric fat, the tumor could be located by the intra-operative B-mode ultrasound after exposing the general boundaries of tumor and normal renal tissues, and the boundaries were marked with electric knife. The adherent adipose tissue and tumor were both resected with scissors along the marking line after blocking the blood flow. Results The operations were successfully completed in all the 16 patients, and the intra-operative B-mode ultrasound positioning was used in 5 cases. The maximal diameter of tumor was 2.1-3.5 (2.8±0.4) cm, the Mayo adhesive probability (MAP) score was 3-5 (3.8±0.7), the renal artery occlusion time was 20-31 (25.6±3.1) min, and the operation time was 90-133 (112.0±10.5) min. During a follow-up of 6-20 months, no patients had recurrence or metastasis. Conclusion It is important to locate the tumor boundaries during laparoscopic partial nephrectomy in patients with adherent perinephric fat, and the intra-operative B-mode ultrasound can be used if necessary. The tumor and adherent adipose tissue must be both resected to avoid forced separation of perirenal fat from renal capsule.