TY - JOUR
T1 - Comparison of Open and Robot Assisted Radical Nephrectomy With Level I and II Inferior Vena Cava Tumor Thrombus
T2 - The Mayo Clinic Experience
AU - Rose, Kyle M.
AU - Navaratnam, Anojan K.
AU - Faraj, Kassem S.
AU - Abdul-Muhsin, Haidar M.
AU - Syal, Amit
AU - Elias, Laila
AU - Moss, Adyr A.
AU - Eversman, William George
AU - Stone, William M.
AU - Money, Samuel R.
AU - Davila, Victor J.
AU - Tyson, Mark D.
AU - Castle, Erik P.
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Objective: To compare the perioperative and oncologic outcomes associated with open radical nephrectomy with tumor thrombus (O-RNTT) vs robot assisted radical nephrectomy with tumor thrombus (RA-RNTT). Renal cell carcinoma with venous tumor thrombus has traditionally been managed through an open surgical approach. The robot assisted approach may offers improved perioperative outcomes compared to open, but there are few studies comparing these 2. Methods: We analyzed patients with renal cell carcinoma and inferior vena cava tumor thrombus between 1998 and 2018, comparing perioperative and oncologic outcomes of these patients with Level I and Level II thrombus. Cohorts were stratified by surgical approach: O-RNTT vs RA-RNTT. Univariate analysis was conducted using chi-squared test and t tests when appropriate. Kaplan-Meier estimates were used to evaluate survival. Results and Limitation: Twenty-seven patients were in the O-RNTT group, and 24 in the RA-RNTT group. Patients in the RA-RNTT group, compared to the O-RNTT group, demonstrated shorter length of stay (3 vs 7 nights, P = .03), lower estimate blood loss (450 vs 1800 mL, P <.01), and lower transfusion rate (21% vs 82%, P <.01). The RA-RNTT group had 26% fever complications compared to the open (17% vs 43%, P <.01). There was no significant difference in estimated overall survival or recurrence-free survival between the O-RNTT and RA-RNTT groups. Conclusion: RA-RNTT produced a shorter length of stay, less transfusions, and a lower rate of complications with no significant difference in overall survival.
AB - Objective: To compare the perioperative and oncologic outcomes associated with open radical nephrectomy with tumor thrombus (O-RNTT) vs robot assisted radical nephrectomy with tumor thrombus (RA-RNTT). Renal cell carcinoma with venous tumor thrombus has traditionally been managed through an open surgical approach. The robot assisted approach may offers improved perioperative outcomes compared to open, but there are few studies comparing these 2. Methods: We analyzed patients with renal cell carcinoma and inferior vena cava tumor thrombus between 1998 and 2018, comparing perioperative and oncologic outcomes of these patients with Level I and Level II thrombus. Cohorts were stratified by surgical approach: O-RNTT vs RA-RNTT. Univariate analysis was conducted using chi-squared test and t tests when appropriate. Kaplan-Meier estimates were used to evaluate survival. Results and Limitation: Twenty-seven patients were in the O-RNTT group, and 24 in the RA-RNTT group. Patients in the RA-RNTT group, compared to the O-RNTT group, demonstrated shorter length of stay (3 vs 7 nights, P = .03), lower estimate blood loss (450 vs 1800 mL, P <.01), and lower transfusion rate (21% vs 82%, P <.01). The RA-RNTT group had 26% fever complications compared to the open (17% vs 43%, P <.01). There was no significant difference in estimated overall survival or recurrence-free survival between the O-RNTT and RA-RNTT groups. Conclusion: RA-RNTT produced a shorter length of stay, less transfusions, and a lower rate of complications with no significant difference in overall survival.
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U2 - 10.1016/j.urology.2019.11.002
DO - 10.1016/j.urology.2019.11.002
M3 - Article
C2 - 31733271
AN - SCOPUS:85076565856
SN - 0090-4295
JO - Urology
JF - Urology
ER -