title: Laparoscopic donor nephrectomy: effect of perirenal fat upon donor operative time.
abstract: OBJECTIVE
  Previous attempts to correlate preoperative patient characteristics with operative complexity and operative time prior to laparoscopic donor nephrectomy have found few consistent relationships. The purpose of this study is to determine the effect of abdominal and perirenal fat measured with preoperative computerized tomography (CT) upon subsequent operative time and complexity during hand-assisted laparoscopic donor nephrectomy.
  
  
  METHODS
  A retrospective chart, database, and CT angiogram review was conducted on 103 consecutive patients who underwent a hand-assisted laparoscopic donor nephrectomy. Perirenal fat and abdominal wall fat were correlated with a variety of parameters including operative time. Univariate and multivariate regression analysis was performed and p values<0.05 were considered significant.
  
  
  RESULTS
  There was no correlation between operative time and body mass index (BMI), abdominal fat measurements, or spleno-renal distance. There was a significant positive correlation between operative time and anterior perirenal fat (r=0.28, p=0.005), posterior perirenal fat (r=0.20, p=0.05), and donor CPK levels (r=0.53, p<0.001). Men had greater perirenal fat, while women had greater abdominal fat. A multivariate model including anterior perirenal fat measurement accounted for 20% of the variance in operative time.
  
  
  CONCLUSIONS
  This is the first study to demonstrate that increased perirenal fat increases operative complexity as measured by operative time. This information may potentially be used to help predict operative complexity based upon measurable preoperative variables and help improve operating room efficiency and donor and recipient outcomes.
authors.affiliation: Department of Urology Loma Linda University Medical Center, Loma Linda, California 92354, USA.
authors.forename: Kirk M
authors.initials: KM
authors.lastname: Anderson
authors.forename: Tekisha U
authors.initials: TU
authors.lastname: Lindler
authors.forename: Gregory R
authors.initials: GR
authors.lastname: Lamberton
authors.forename: Pedro W
authors.initials: PW
authors.lastname: Baron
authors.forename: Okechukwu K
authors.initials: OK
authors.lastname: Ojogho
authors.forename: D Duane
authors.initials: DD
authors.lastname: Baldwin
mesh_terms: D000273:Adipose Tissue / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000601:surgery*; D010535:Laparoscopy; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011182:Postoperative Care; D011300:Preoperative Care; D013154:Spleen / Q000000981:diagnostic imaging; D013997:Time Factors; D014057:Tomography, X-Ray Computed