Comparison of robot-assisted and open surgery in the treatment of renal carcinoma with Mayo Ⅰ-Ⅲ inferior vena cava tumor thrombus
10.3969/j.issn.1009-8291.2023.05.004
- VernacularTitle:机器人辅助与开放手术治疗肾癌并Mayo Ⅰ~Ⅲ 级下腔静脉癌栓的效果比较
- Author:
Ali ZHU
1
;
Jin TAO
1
;
Jinshan CUI
1
;
Shengzheng WANG
1
;
Shuanbao YU
1
;
Yafeng FAN
1
;
Zhaowei ZHU
1
;
Biao DONG
1
;
Xuepei ZHANG
1
,
2
Author Information
1. Department of Urology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052
2. Key Laboratory of Precision Diagnosis and Treatment for Chronic Kidney Disease in Henan Province, Zhengzhou 450052, China
- Publication Type:Journal Article
- Keywords:
robotics;
open surgery;
inferior vena cava tumor thrombus;
radical nephrectomy;
tumor thrombectomy
- From:
Journal of Modern Urology
2023;28(5):382-386
- CountryChina
- Language:Chinese
-
Abstract:
【Objective】 To compare the clinical efficacy of robot-assisted and open surgery in the treatment of renal carcinoma with inferior vena cava cancer thrombus, and to analyze the safety and feasibility of robot-assisted radical nephrectomy. 【Methods】 Clinical data of 55 patients surgically treated for renal carcinoma with Mayo Ⅰ-Ⅲ inferior vena cava tumor thrombus during Dec.2015 and Dec.2021 were retrospectively analyzed. Based on the operation methods, the patients were divided into the robotic surgery group (n=36) and open surgery group (n=19). The perioperative data, oncological results and survival of the two groups were compared. 【Results】 All operations were successful. The median operation time was 176 (IQR:137-234) min, and grade Ⅲ and above complications occurred in 9(16.4%) cases. The robotic surgery group had lower intraoperative blood loss [300 (IQR:200-625) mL vs.1 000 (IQR:600-1 184) mL] and blood transfusion ratio [(20/36) vs. (18/19)] than the open surgery group, but higher postoperative hemoglobin level[109(98-120) g/L vs. 90(84-100) g/L]. During a median follow-up of 26 (IQR:19-39) months, 19(34.5%) patients developed new metastases and 12(21.8%) patients died. The postoperative tumor-specific survival (HR=0.39, 95%CI:0.13-1.16, P=0.090) and overall survival (HR=0.71, 95%CI:0.22-2.23,P=0.554) were not significantly different between the two groups. 【Conclusion】 There are no significant differences in the incidence of postoperative complications, tumor-specific survival and overall survival between robot-assisted and open surgery for Mayo Ⅰ-Ⅲ inferior vena cava tumor thrombus, but the intraoperative blood loss in robotic group is lower than that in the open surgery group.
