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.