Introduction
The dissection of perirenal fat is of critical importance to kidney surgery, especially in cases of partial and donor nephrectomy. Good dissection of perirenal fat provides good exposure, easy manipulation, and shorter surgical duration1,2. In 10.6%-55.2% of cases perirenal fat tissue is adhered to the kidney, which makes it difficult to dissect; this phenomenon is referred to as adherent perirenal fat(APF) or sticky perirenal fat2.
Patient-related factors, including gender, and visceral and perinephric fat thickness are clinically associated with the complexity of surgery and surgical outcome1,3. For predicting the complexity of perirenal fat dissection many researchers suggest using such tools as renal scoring systems and pre-operative computed tomography (CT) measurement4,5. Prediction of APF can help in choosing the optimal surgical approach. Severe APF can complicate and hinder minimally invasive surgery.
All relevant studies in the literature have emphasized the prediction of APF pre-operatively, with very little attention to the underlying pathophysiology. Recently, Dariane et al. published a study on the histological changes linked to APF6. The present study aimed to determine the clinical, radiological, and pathological significance of APF.