AUA 2018: Comparison of Robotic and Open Techniques in Patients Undergoing Radical Nephrectomy and Level II Inferior Vena Cava Thrombectomy

San Francisco, CA USA ( Alp Tuna Beksac from the Icahn School of Medicine at Mount Sinai, New York, NY, presented an evaluation of the safety and feasibility of robot assisted laparoscopic radical nephrectomy for patients with clinical T3 renal masses, level II IVC thrombus. As an introduction to his talk, Beksac stated that inferior vena cava (IVC) thrombectomy is a technically challenging procedure that is a relative indication for open surgery.

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