They used a multi-institutional database to identify 20 patients who underwent robotic or open radical nephrectomy (RN) with a level II IVC thrombus. Their outcome measures included operative time, estimated blood loss (EBL), blood transfusion rates, and complications.
When they looked at the baseline characteristics between the two groups, the only difference was the Charlson Comorbidity Index (3 robotic vs. 0 open, p=0.004). He stated that two patients in the robotic group were converted to open surgery, and perioperative complication rate was similar between the two groups (22.2% open vs. 9.2% robotic, p>0.999). However, the robotic group had a decreased estimated blood loss (100 mL vs. 600 mL, p=0.004) and a shorter length of stay (1 day vs. 5 days, p=0.020). Lastly, the transfusion rate was higher in the open group, but no significance was observed.
Beksac concluded that in select cases and experienced hands, a robotic approach is a feasible alternative to open surgery.
Presented by: Alp Tuna Beksac, MD
Written by: Kaelyn See, Department of Urology, University of California-Irvine at the 2018 AUA Annual Meeting - May 18 - 21, 2018 – San Francisco, CA USA