Robotic-assisted Laparoscopic Nephrectomy with Vein Thrombectomy: Initial Experience and Outcomes from a Single Surgeon

Ke, Xinwen; Zeng, Xing; Xian, Wa; Shen, Yuanqing; Gan, Jiahua; Tian, Jing; Hu, Zhiquan

doi:10.1007/s11596-018-1950-x

Cited by 2 publications

(1 citation statement)

References 16 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%

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%