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
2
Author Information
1. Department of Urology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052
2. Department of Urology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052; 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.
