Robotic-assisted Radical Nephrectomy With Retrohepatic Vena Caval Tumor Thrombectomy (Level III) Combined With Extended Retroperitoneal Lymph Node Dissection

Bratslavsky, Gennady; Cheng, Jed-Sian

doi:10.1016/j.urology.2015.05.042

Cited by 32 publications

(13 citation statements)

References 12 publications

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“…2010 LS CO with a Satinsky or similar clamp 0/6 240 (159–330) 550 (400–4250) Na IV:2 II:5 III:1 Na 15 (6–42) One lung metastasis and died Shao P et al [ 19 ]. 2015 LS CO with bulldog clamp (vessel loop) 0/6 155 (135–210) 275 (150–510) 16.5 (13–20) I-II:2 II:6 NA 32.5 (16–52) Disease free Bratslavsky G et al [ 20 ]. 2015 RALS CO with vessel loop 0/1 366 1200 NA No III:1 Clear cell RCC 20 Disease free Wang M et al [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Pure retroperitoneal laparoscopic radical nephrectomy and thrombectomy with delayed occlusion of the proximal inferior vena cava (DOPI) technique for renal tumor with level II-III venous tumor thrombus

et al. 2021

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Purpose To explore the safety and effectiveness of delayed occlusion of the proximal inferior vena cava (DOPI) technique in retroperitoneal laparoscopic radical nephrectomy (LRN) and thrombectomy for renal tumor with level II-III venous tumor thrombus (VTT). Materials and methods From August 2016 to October 2018, a total of 145 patients with renal tumor and VTT were admitted to our centre. Seventy-five patients underwent laparoscopic surgery, and 70 patients underwent open surgery. Among these patients, 17 patients underwent retroperitoneal LRN and thrombectomy with the DOPI technique. Clinical data were collected retrospectively, and a descriptive statistical analysis was conducted. Results All the patients successfully underwent retroperitoneal laparoscopic surgery. The mean operation time was 345.9 ± 182.9 min, the mean estimated blood loss was 466.7 ± 245.5 ml. Postoperative complications occurred in three patients, including two patients of Clavien grading system level IVa and one patient of level II. There were no complications related to carbon dioxide pneumoperitoneum, such as gas embolism, acidosis, and subcutaneous emphysema. During 21 months of median follow-up time, no local recurrence was found, and distant metastasis occurred in four patients. Cancer-specific death occurred in two patients. Conclusions The DOPI technique is safe and feasible in the treatment of renal tumor and level II-III VTT. With the DOPI technique, the procedures of dissociating and exposing proximal inferior vena cava are simplified.

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Section: Discussionmentioning

confidence: 99%

Pure retroperitoneal laparoscopic radical nephrectomy and thrombectomy with delayed occlusion of the proximal inferior vena cava (DOPI) technique for renal tumor with level II-III venous tumor thrombus

et al. 2021

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“…This procedure is technically challenging and involves a large incision and prolonged convalescence [9]. Recently, the feasibility of robotic IVC thrombectomy has been demonstrated, with potential lower EBL and shorter hospitalization and convalescence [7,[10][11][12][13][14]. This surgery requires thorough knowledge of surgical anatomy, detailed pre-operative preparation and meticulous robotic technique [7].…”

Section: Introductionmentioning

confidence: 99%

3D software reconstruction for planning robotic assisted radical nephrectomy with level III caval thrombus

Tobias-Machado¹,

Bragança²,

Tourinho-Barbosa³

et al. 2020

Arch Cancer Sci Ther

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“…Operative times were relatively long, median 327 minutes (range, 240-411 minutes), but in this early series, patients generally did well with short lengths of stay, mean 1.2 days (range, 1-2 days), and no significant complications. In 2015, robotic management of level III thrombi was reported, but cohort size remained limited (4,5). Gill and colleagues published an initial series of 16 cases, 9 of which were level III without open conversion or mortality.…”

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confidence: 99%

Robotic renal surgery for renal cell carcinoma with inferior vena cava thrombus

Masic¹,

Smaldone²

2021

Transl Androl Urol

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Surgical management of renal cell carcinoma (RCC) with inferior vena cava (IVC) thrombus is inherently complex, posing challenges for even the most experienced urologists. Until the mid-2000s, nephrectomy with IVC thrombectomy was exclusively performed using variations of the open technique initially described decades earlier, but since then several institutions have reported their robotic experiences.Robotic IVC thrombectomy was initially reported for level I and II thrombi, and more recently in higherlever III thrombi. In general, the robotic approach is associated with less blood loss and shorter hospital stays compared to the open approach, low rates of open conversion in reported cases, relatively low rates of high-grade complications, and favorable overall survival on short-term follow-up in limited cohorts.Operative times are longer, costs are significantly higher, and left-sided tumors always require intraoperative repositioning and usually require preoperative embolization. To date, criteria for patient selection or open conversion have not been defined, and long-term oncologic outcomes are lacking. While the early published robotic experience demonstrates feasibility and safety in carefully selected patients, longer-term follow-up remains necessary. Patient selection, indications for open conversion, logistics of conversion particularly in emergent settings, necessity and safety of preoperative embolization, the value proposition, and long-term oncologic outcomes must all be clearly defined before this approach is widely adopted.

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Robotic-assisted Radical Nephrectomy With Retrohepatic Vena Caval Tumor Thrombectomy (Level III) Combined With Extended Retroperitoneal Lymph Node Dissection

Cited by 32 publications

References 12 publications

Pure retroperitoneal laparoscopic radical nephrectomy and thrombectomy with delayed occlusion of the proximal inferior vena cava (DOPI) technique for renal tumor with level II-III venous tumor thrombus

Pure retroperitoneal laparoscopic radical nephrectomy and thrombectomy with delayed occlusion of the proximal inferior vena cava (DOPI) technique for renal tumor with level II-III venous tumor thrombus

3D software reconstruction for planning robotic assisted radical nephrectomy with level III caval thrombus

Robotic renal surgery for renal cell carcinoma with inferior vena cava thrombus

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