Robotic versus Open Level I-II Inferior Vena Cava Thrombectomy: A Matched Group Comparative Analysis

No AccessJournal of UrologyAdult Urology1 Dec 2017Robotic versus Open Level I-II Inferior Vena Cava Thrombectomy: A Matched Group Comparative Analysis Liangyou Gu, Xin Ma, Yu Gao, Hongzhao Li, Xintao Li, Luyao Chen, Baojun Wang, Yongpeng Xie, Yang Fan, and Xu Zhang Liangyou GuLiangyou Gu Equal study contribution. More articles by this author , Xin MaXin Ma Equal study contribution. More articles by this author , Yu GaoYu Gao Equal study contribution. More articles by this author , Hongzhao LiHongzhao Li More articles by this author , Xintao LiXintao Li More articles by this author , Luyao ChenLuyao Chen More articles by this author , Baojun WangBaojun Wang More articles by this author , Yongpeng XieYongpeng Xie More articles by this author , Yang FanYang Fan More articles by this author , and Xu ZhangXu Zhang More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.06.094AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We compared treatment outcomes of robotic vs open inferior vena cava thrombectomy for renal tumors with level I-II inferior vena cava tumor thrombus. Materials and Methods: We retrospectively reviewed the medical records of patients who underwent robotic or open inferior vena cava thrombectomy between 2006 and 2016. To reduce the inherent biases of a nonrandomized study the robotic and open groups were matched 1:1 based on key variables. Perioperative data and oncologic outcomes were reviewed. Progression-free and overall survival was analyzed using Kaplan-Meier survival curves and compared between groups using the log rank test. Results: A total of 31 and 37 patients underwent robotic and open inferior vena cava thrombectomy, respectively. After matching there were no significant differences in baseline characteristics between the groups. Of the matched cohorts the robotic cohort had significantly shorter median operative time (150 vs 230 minutes, p <0.001), lower median estimated blood loss (250 vs 1,000 ml, p <0.001), a lower rate of blood transfusion (6.5% vs 54.8%, p <0.001), a lower median transfusion requirement (420 vs 790 ml, p = 0.012) and a shorter median postoperative hospital stay (5 vs 9 days, p <0.001). The postoperative complication rate was lower in the robotic group than in the open group (9.7% vs 29.0%, p = 0.070). However, there were no significant differences in oncologic outcomes between the groups. Conclusions: Robotic inferior vena cava thrombectomy can achieve more favorable perioperative results and similar oncologic outcomes compared with open inferior vena cava thrombectomy. Prospective studies with a larger sample size and longer followup are needed to validate our findings. References 1 : Surgical management of renal cell carcinoma with intracaval neoplastic extension above the hepatic veins. J Urol1988; 139: 1166. Link, Google Scholar 2 : Extension of renal cell carcinoma into the vena cava: the rationale for aggressive surgical management. J Urol1972; 107: 711. Link, Google Scholar 3 : The surgical management and prognosis of renal cell cancer with IVC tumor thrombus: 15-years of experience using a multi-specialty approach at a single UK referral center. 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Volume 198Issue 6December 2017Page: 1241-1246Supplementary Materials Advertisement Copyright & Permissions© 2017 by American Urological Association Education and Research, Inc.Keywordsthrombosisinferiornephrectomyvena cavarobotic surgical proceduresrenal cellcarcinomaMetricsAuthor Information Liangyou Gu Equal study contribution. More articles by this author Xin Ma Equal study contribution. More articles by this author Yu Gao Equal study contribution. More articles by this author Hongzhao Li More articles by this author Xintao Li More articles by this author Luyao Chen More articles by this author Baojun Wang More articles by this author Yongpeng Xie More articles by this author Yang Fan More articles by this author Xu Zhang More articles by this author Expand All Advertisement PDF downloadLoading ...