Radical robot-assisted laparoscopic nephrectomy with thrombectomy in the vena cava

Zarranz, Javier Estébanez; Loidi, J. Belloso; García, Mercedes Ávila; Calaveras, V. Rubio; Higelmo, G. Morales; Tercilla, P. Melendo; Leis, L.; Jaka, J. P. Sanz

doi:10.1016/j.acuroe.2018.07.008

Cited by 2 publications

(3 citation statements)

References 7 publications

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“…Table 1 summarizes the various case reports and case studies reporting outcomes of R-CT. A total of 21 studies were included. 10,21–40 All the studies were published in English except for 1, for which an English translation was retrieved. 33 Eight (38.1%) of the 21 single-arm studies were case reports involving 1 or 2 patients, and 9 (42.9%) included more than 10 patients.…”

Section: Resultsmentioning

confidence: 99%

“…10,21–40 All the studies were published in English except for 1, for which an English translation was retrieved. 33 Eight (38.1%) of the 21 single-arm studies were case reports involving 1 or 2 patients, and 9 (42.9%) included more than 10 patients. All studies provided level 4 evidence according to the Oxford classification, 13 and most were classified as phase 1 or 2a for surgical innovation based on the IDEAL recommendations (Table 1).…”

Section: Resultsmentioning

confidence: 99%

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A Decade of Robotic-Assisted Radical Nephrectomy with Inferior Vena Cava Thrombectomy: A Systematic Review and Meta-Analysis of Perioperative Outcomes

Garg¹,

Psutka

Hakimi

et al. 2022

Journal of Urology

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Purpose:Open radical nephrectomy with inferior vena cava thrombectomy (O-CT) is standard management for renal cell carcinoma with inferior vena cava thrombus. First reported a decade ago, robotic-assisted radical nephrectomy with inferior vena cava thrombectomy (R-CT) is a minimally invasive option for this disease. We aimed to perform a systematic review to assess the safety and feasibility of R-CT in terms of perioperative outcomes and compare the outcomes between R-CT and O-CT.Materials and Methods:The PubMed®, Scopus®, Cochrane Central Register of Controlled Trials and Web of ScienceTM databases were searched using the free-text and MeSH terms “renal cell carcinoma,” “inferior vena cava,” “thrombosis” or “thrombus,” “robot” and “thrombectomy.” Studies reporting perioperative outcomes of R-CT and studies comparing R-CT with O-CT were included. The review was done in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.Results:The search retrieved 28 articles describing R-CT, including 7 comparative studies. This systematic review included 1,375 patients, out of which 329 patients were in single-arm studies and 1,046 patients were in comparative studies. Of the 329 patients who underwent R-CT, 14.7% were level I, 60.9% level II, 20.4% level III and 2.5% level IV thrombus. Operative time ranged from 150 to 530 minutes; blood transfusion was administered in 38.2% (126). The overall complication rate was 30.3% (99). R-CT, in comparison to O-CT, was associated with a lower blood transfusion rate (18.4% vs 64.3%, p=0.002) and a lower complication rate (14.5% vs 36.7%, p=0.005). Major complication and 30-day mortality rates were similar in both groups.Conclusions:R-CT has acceptable perioperative outcomes in carefully selected patients. Compared with O-CT, R-CT is associated with a lower blood transfusion rate and fewer overall complications. In experienced hands with carefully selected patients, R-CT is feasible and safe, with acceptable outcomes; however, selection bias limits definitive inference of these results, and optimal patient selection criteria remain to be described.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

A Decade of Robotic-Assisted Radical Nephrectomy with Inferior Vena Cava Thrombectomy: A Systematic Review and Meta-Analysis of Perioperative Outcomes

Garg¹,

Psutka

Hakimi

et al. 2022

Journal of Urology

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“…The introduction of robotic-assisted technology has enabled urologists to perform IVC thrombectomy in a minimally invasive manner with the potential to reduce perioperative morbidity including reduced blood loss and transfusions, as well as shorter operating times and length of hospital stay while overcoming the limitations of a purely laparoscopic approach (86,87). There have been several successful reports demonstrating the safety and feasibility of a robotic-assisted approach to IVC tumor thrombectomy for level 0, I and II thrombi in experienced hands (86)(87)(88)(89)(90)(91)(92)(93)(94)(95). Our preoperative preparation, port placement, and "IVC-first, kidney-last approach" to level II-III thrombi has been reported previously (93).…”

Section: Minimally Invasive Ivc Tumor Thrombectomymentioning

confidence: 99%

Minimally invasive radical nephrectomy: a contemporary review

Ashrafi

Gill

2020

Transl Androl Urol

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Minimally invasive renal surgery has revolutionized the surgical management of renal cancer since the initial report of laparoscopic nephrectomy in 1991. Laparoscopic nephrectomy became the mainstay of management in surgically resectable renal masses since the 1990s. The growing body of literature supporting nephron-sparing surgery over the last two decades has meant that minimally invasive radical nephrectomy (MI-RN) is now the preferred treatment for renal tumors not amenable to partial nephrectomy. While there is a well-described experience with complex radical nephrectomy using standard laparoscopy, robot-assisted surgery has shortened the learning curve and facilitated greater uptake of minimally invasive surgery in difficult surgical scenarios traditionally performed open surgically. Increased experience and expertise with robot-assisted renal surgery has led to expansion of the indications for MI-RN to include larger masses, locally advanced renal masses invading adjacent tissues or regional hilar/ retroperitoneal lymph nodes, cytoreductive nephrectomy (CN) in metastatic disease, and concurrent venous tumor thrombectomy for renal vein or inferior vena cava (IVC) involvement. In this article, we review the various surgical techniques and adjunctive procedures associated with MI-RN.

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Radical robot-assisted laparoscopic nephrectomy with thrombectomy in the vena cava

Cited by 2 publications

References 7 publications

A Decade of Robotic-Assisted Radical Nephrectomy with Inferior Vena Cava Thrombectomy: A Systematic Review and Meta-Analysis of Perioperative Outcomes

A Decade of Robotic-Assisted Radical Nephrectomy with Inferior Vena Cava Thrombectomy: A Systematic Review and Meta-Analysis of Perioperative Outcomes

Minimally invasive radical nephrectomy: a contemporary review

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