Robot-assisted Cavectomy Versus Thrombectomy for Level II Inferior Vena Cava Thrombus: Decision-making Scheme and Multi-institutional Analysis
Background: Robot-assisted thrombectomy (RAT) for inferior vena cava (IVC) thrombus (RAT-IVCT) is being increasingly reported. However, the techniques and indications for robot-assisted cavectomy (RAC) for IVC thrombus are not well described.Objective: To develop a decision-making program and analyz...
Ausführliche Beschreibung
Gespeichert in:
| Autor*in: |
Shi, Taoping [verfasserIn] Huang, Qingbo [verfasserIn] Liu, Kan [verfasserIn] Du, Songliang [verfasserIn] Fan, Yang [verfasserIn] Yang, Luojia [verfasserIn] Peng, Cheng [verfasserIn] Shen, Dan [verfasserIn] Wang, Zhongxin [verfasserIn] Gao, Yu [verfasserIn] Gu, Liangyou [verfasserIn] Niu, Shaoxi [verfasserIn] Ai, Qing [verfasserIn] Li, Hongzhao [verfasserIn] Liu, Fengyong [verfasserIn] Li, Qiuyang [verfasserIn] Wang, Haiyi [verfasserIn] Guo, Aitao [verfasserIn] Fu, Bin [verfasserIn] Yang, Xiaojian [verfasserIn] Zhang, Xuepei [verfasserIn] Wang, Delin [verfasserIn] Wang, Dongwen [verfasserIn] Guo, Hongqian [verfasserIn] Li, Hengping [verfasserIn] Olivero, Alberto [verfasserIn] Fam, Xeng Inn [verfasserIn] Ma, Xin [verfasserIn] Wang, Baojun [verfasserIn] Zhang, Xu [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2020 |
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| Schlagwörter: |
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| Übergeordnetes Werk: |
Enthalten in: European urology - Amsterdam [u.a.] : Elsevier Science, 1976, 78, Seite 592-602 |
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| Übergeordnetes Werk: |
volume:78 ; pages:592-602 |
| DOI / URN: |
10.1016/j.eururo.2020.03.020 |
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ELV004677021 |
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| 024 | 7 | |a 10.1016/j.eururo.2020.03.020 |2 doi | |
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| 245 | 1 | 0 | |a Robot-assisted Cavectomy Versus Thrombectomy for Level II Inferior Vena Cava Thrombus: Decision-making Scheme and Multi-institutional Analysis |
| 264 | 1 | |c 2020 | |
| 336 | |a nicht spezifiziert |b zzz |2 rdacontent | ||
| 337 | |a Computermedien |b c |2 rdamedia | ||
| 338 | |a Online-Ressource |b cr |2 rdacarrier | ||
| 520 | |a Background: Robot-assisted thrombectomy (RAT) for inferior vena cava (IVC) thrombus (RAT-IVCT) is being increasingly reported. However, the techniques and indications for robot-assisted cavectomy (RAC) for IVC thrombus are not well described.Objective: To develop a decision-making program and analyze multi-institutional outcomes of RAC-IVCT versus RAT-IVCT.Design, setting, and participants: Ninety patients with renal cell carcinoma (RCC) with level II IVCT were included from eight Chinese urological centers, and underwent RAC-IVCT (30 patients) or RAT-IVCT (60 patients) from June 2013 to January 2019.Surgical procedure: The surgical strategy was based on IVCT imaging characteristics. RAT-IVCT was performed with standardized cavotomy, thrombectomy, and IVC reconstruction. RAC-IVCT was mainly performed in patients with extensive IVC wall invasion when the collateral blood vessels were well-established. For right-sided RCC, the IVC from the infrarenal vein to the infrahepatic veins was stapled. For left-sided RCC, the IVC from the suprarenal vein to the infrahepatic veins was removed and caudal IVC reconstruction was performed to ensure the right renal vein returned through the IVC collaterals.Measurements: Clinicopathological, operative, and survival outcomes were collected and analyzed.Results and limitations: All procedures were successfully performed without open conversion. The median operation time (268 vs 190 min) and estimated blood loss (1500 vs 400 ml) were significantly greater for RAC-IVCT versus RAT-IVCT (both p < 0.001). IVC invasion was a risk factor for progression-free and overall survival at midterm follow-up. Large-volume and long-term follow-up studies are needed.Conclusions: RAC-IVCT or RAT-IVCT represents an alternative minimally invasive approach for selected RCC patients with level II IVCT. Selection of RAC-IVCT or RAT-IVCT is mainly based on preoperative IVCT imaging characteristics, including the presence of IVC wall invasion, the affected kidney, and establishment of the collateral circulation.Patient summary: In this study we found that robotic surgeries for level II inferior vena cava thrombus were feasible and safe. Preoperative imaging played an important role in establishing an appropriate surgical plan. | ||
| 650 | 4 | |a Robotics | |
| 650 | 4 | |a Laparoscopy | |
| 650 | 4 | |a Nephrectomy | |
| 650 | 4 | |a Renal cell carcinoma | |
| 650 | 4 | |a Thrombus | |
| 650 | 4 | |a Inferior vena cava | |
| 650 | 4 | |a Vascular resection | |
| 700 | 1 | |a Huang, Qingbo |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Kan |e verfasserin |4 aut | |
| 700 | 1 | |a Du, Songliang |e verfasserin |4 aut | |
| 700 | 1 | |a Fan, Yang |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Luojia |e verfasserin |4 aut | |
| 700 | 1 | |a Peng, Cheng |e verfasserin |4 aut | |
| 700 | 1 | |a Shen, Dan |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Zhongxin |e verfasserin |4 aut | |
| 700 | 1 | |a Gao, Yu |e verfasserin |4 aut | |
| 700 | 1 | |a Gu, Liangyou |e verfasserin |4 aut | |
| 700 | 1 | |a Niu, Shaoxi |e verfasserin |4 aut | |
| 700 | 1 | |a Ai, Qing |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Hongzhao |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Fengyong |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Qiuyang |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Haiyi |e verfasserin |0 (orcid)0000-0002-0717-1748 |4 aut | |
| 700 | 1 | |a Guo, Aitao |e verfasserin |4 aut | |
| 700 | 1 | |a Fu, Bin |e verfasserin |4 aut | |
| 700 | 1 | |a Yang, Xiaojian |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Xuepei |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Delin |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Dongwen |e verfasserin |4 aut | |
| 700 | 1 | |a Guo, Hongqian |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Hengping |e verfasserin |4 aut | |
| 700 | 1 | |a Olivero, Alberto |e verfasserin |4 aut | |
| 700 | 1 | |a Fam, Xeng Inn |e verfasserin |4 aut | |
| 700 | 1 | |a Ma, Xin |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Baojun |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Xu |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t European urology |d Amsterdam [u.a.] : Elsevier Science, 1976 |g 78, Seite 592-602 |h Online-Ressource |w (DE-627)300191596 |w (DE-600)1482253-2 |w (DE-576)099718103 |x 1873-7560 |7 nnns |
| 773 | 1 | 8 | |g volume:78 |g pages:592-602 |
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10.1016/j.eururo.2020.03.020 doi (DE-627)ELV004677021 (ELSEVIER)S0302-2838(20)30195-0 DE-627 ger DE-627 rda eng 610 DE-600 44.88 bkl Shi, Taoping verfasserin aut Robot-assisted Cavectomy Versus Thrombectomy for Level II Inferior Vena Cava Thrombus: Decision-making Scheme and Multi-institutional Analysis 2020 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Robot-assisted thrombectomy (RAT) for inferior vena cava (IVC) thrombus (RAT-IVCT) is being increasingly reported. However, the techniques and indications for robot-assisted cavectomy (RAC) for IVC thrombus are not well described.Objective: To develop a decision-making program and analyze multi-institutional outcomes of RAC-IVCT versus RAT-IVCT.Design, setting, and participants: Ninety patients with renal cell carcinoma (RCC) with level II IVCT were included from eight Chinese urological centers, and underwent RAC-IVCT (30 patients) or RAT-IVCT (60 patients) from June 2013 to January 2019.Surgical procedure: The surgical strategy was based on IVCT imaging characteristics. RAT-IVCT was performed with standardized cavotomy, thrombectomy, and IVC reconstruction. RAC-IVCT was mainly performed in patients with extensive IVC wall invasion when the collateral blood vessels were well-established. For right-sided RCC, the IVC from the infrarenal vein to the infrahepatic veins was stapled. For left-sided RCC, the IVC from the suprarenal vein to the infrahepatic veins was removed and caudal IVC reconstruction was performed to ensure the right renal vein returned through the IVC collaterals.Measurements: Clinicopathological, operative, and survival outcomes were collected and analyzed.Results and limitations: All procedures were successfully performed without open conversion. The median operation time (268 vs 190 min) and estimated blood loss (1500 vs 400 ml) were significantly greater for RAC-IVCT versus RAT-IVCT (both p < 0.001). IVC invasion was a risk factor for progression-free and overall survival at midterm follow-up. Large-volume and long-term follow-up studies are needed.Conclusions: RAC-IVCT or RAT-IVCT represents an alternative minimally invasive approach for selected RCC patients with level II IVCT. Selection of RAC-IVCT or RAT-IVCT is mainly based on preoperative IVCT imaging characteristics, including the presence of IVC wall invasion, the affected kidney, and establishment of the collateral circulation.Patient summary: In this study we found that robotic surgeries for level II inferior vena cava thrombus were feasible and safe. Preoperative imaging played an important role in establishing an appropriate surgical plan. Robotics Laparoscopy Nephrectomy Renal cell carcinoma Thrombus Inferior vena cava Vascular resection Huang, Qingbo verfasserin aut Liu, Kan verfasserin aut Du, Songliang verfasserin aut Fan, Yang verfasserin aut Yang, Luojia verfasserin aut Peng, Cheng verfasserin aut Shen, Dan verfasserin aut Wang, Zhongxin verfasserin aut Gao, Yu verfasserin aut Gu, Liangyou verfasserin aut Niu, Shaoxi verfasserin aut Ai, Qing verfasserin aut Li, Hongzhao verfasserin aut Liu, Fengyong verfasserin aut Li, Qiuyang verfasserin aut Wang, Haiyi verfasserin (orcid)0000-0002-0717-1748 aut Guo, Aitao verfasserin aut Fu, Bin verfasserin aut Yang, Xiaojian verfasserin aut Zhang, Xuepei verfasserin aut Wang, Delin verfasserin aut Wang, Dongwen verfasserin aut Guo, Hongqian verfasserin aut Li, Hengping verfasserin aut Olivero, Alberto verfasserin aut Fam, Xeng Inn verfasserin aut Ma, Xin verfasserin aut Wang, Baojun verfasserin aut Zhang, Xu verfasserin aut Enthalten in European urology Amsterdam [u.a.] : Elsevier Science, 1976 78, Seite 592-602 Online-Ressource (DE-627)300191596 (DE-600)1482253-2 (DE-576)099718103 1873-7560 nnns volume:78 pages:592-602 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.88 Urologie Nephrologie AR 78 592-602 |
| spelling |
10.1016/j.eururo.2020.03.020 doi (DE-627)ELV004677021 (ELSEVIER)S0302-2838(20)30195-0 DE-627 ger DE-627 rda eng 610 DE-600 44.88 bkl Shi, Taoping verfasserin aut Robot-assisted Cavectomy Versus Thrombectomy for Level II Inferior Vena Cava Thrombus: Decision-making Scheme and Multi-institutional Analysis 2020 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Robot-assisted thrombectomy (RAT) for inferior vena cava (IVC) thrombus (RAT-IVCT) is being increasingly reported. However, the techniques and indications for robot-assisted cavectomy (RAC) for IVC thrombus are not well described.Objective: To develop a decision-making program and analyze multi-institutional outcomes of RAC-IVCT versus RAT-IVCT.Design, setting, and participants: Ninety patients with renal cell carcinoma (RCC) with level II IVCT were included from eight Chinese urological centers, and underwent RAC-IVCT (30 patients) or RAT-IVCT (60 patients) from June 2013 to January 2019.Surgical procedure: The surgical strategy was based on IVCT imaging characteristics. RAT-IVCT was performed with standardized cavotomy, thrombectomy, and IVC reconstruction. RAC-IVCT was mainly performed in patients with extensive IVC wall invasion when the collateral blood vessels were well-established. For right-sided RCC, the IVC from the infrarenal vein to the infrahepatic veins was stapled. For left-sided RCC, the IVC from the suprarenal vein to the infrahepatic veins was removed and caudal IVC reconstruction was performed to ensure the right renal vein returned through the IVC collaterals.Measurements: Clinicopathological, operative, and survival outcomes were collected and analyzed.Results and limitations: All procedures were successfully performed without open conversion. The median operation time (268 vs 190 min) and estimated blood loss (1500 vs 400 ml) were significantly greater for RAC-IVCT versus RAT-IVCT (both p < 0.001). IVC invasion was a risk factor for progression-free and overall survival at midterm follow-up. Large-volume and long-term follow-up studies are needed.Conclusions: RAC-IVCT or RAT-IVCT represents an alternative minimally invasive approach for selected RCC patients with level II IVCT. Selection of RAC-IVCT or RAT-IVCT is mainly based on preoperative IVCT imaging characteristics, including the presence of IVC wall invasion, the affected kidney, and establishment of the collateral circulation.Patient summary: In this study we found that robotic surgeries for level II inferior vena cava thrombus were feasible and safe. Preoperative imaging played an important role in establishing an appropriate surgical plan. Robotics Laparoscopy Nephrectomy Renal cell carcinoma Thrombus Inferior vena cava Vascular resection Huang, Qingbo verfasserin aut Liu, Kan verfasserin aut Du, Songliang verfasserin aut Fan, Yang verfasserin aut Yang, Luojia verfasserin aut Peng, Cheng verfasserin aut Shen, Dan verfasserin aut Wang, Zhongxin verfasserin aut Gao, Yu verfasserin aut Gu, Liangyou verfasserin aut Niu, Shaoxi verfasserin aut Ai, Qing verfasserin aut Li, Hongzhao verfasserin aut Liu, Fengyong verfasserin aut Li, Qiuyang verfasserin aut Wang, Haiyi verfasserin (orcid)0000-0002-0717-1748 aut Guo, Aitao verfasserin aut Fu, Bin verfasserin aut Yang, Xiaojian verfasserin aut Zhang, Xuepei verfasserin aut Wang, Delin verfasserin aut Wang, Dongwen verfasserin aut Guo, Hongqian verfasserin aut Li, Hengping verfasserin aut Olivero, Alberto verfasserin aut Fam, Xeng Inn verfasserin aut Ma, Xin verfasserin aut Wang, Baojun verfasserin aut Zhang, Xu verfasserin aut Enthalten in European urology Amsterdam [u.a.] : Elsevier Science, 1976 78, Seite 592-602 Online-Ressource (DE-627)300191596 (DE-600)1482253-2 (DE-576)099718103 1873-7560 nnns volume:78 pages:592-602 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.88 Urologie Nephrologie AR 78 592-602 |
| allfields_unstemmed |
10.1016/j.eururo.2020.03.020 doi (DE-627)ELV004677021 (ELSEVIER)S0302-2838(20)30195-0 DE-627 ger DE-627 rda eng 610 DE-600 44.88 bkl Shi, Taoping verfasserin aut Robot-assisted Cavectomy Versus Thrombectomy for Level II Inferior Vena Cava Thrombus: Decision-making Scheme and Multi-institutional Analysis 2020 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Robot-assisted thrombectomy (RAT) for inferior vena cava (IVC) thrombus (RAT-IVCT) is being increasingly reported. However, the techniques and indications for robot-assisted cavectomy (RAC) for IVC thrombus are not well described.Objective: To develop a decision-making program and analyze multi-institutional outcomes of RAC-IVCT versus RAT-IVCT.Design, setting, and participants: Ninety patients with renal cell carcinoma (RCC) with level II IVCT were included from eight Chinese urological centers, and underwent RAC-IVCT (30 patients) or RAT-IVCT (60 patients) from June 2013 to January 2019.Surgical procedure: The surgical strategy was based on IVCT imaging characteristics. RAT-IVCT was performed with standardized cavotomy, thrombectomy, and IVC reconstruction. RAC-IVCT was mainly performed in patients with extensive IVC wall invasion when the collateral blood vessels were well-established. For right-sided RCC, the IVC from the infrarenal vein to the infrahepatic veins was stapled. For left-sided RCC, the IVC from the suprarenal vein to the infrahepatic veins was removed and caudal IVC reconstruction was performed to ensure the right renal vein returned through the IVC collaterals.Measurements: Clinicopathological, operative, and survival outcomes were collected and analyzed.Results and limitations: All procedures were successfully performed without open conversion. The median operation time (268 vs 190 min) and estimated blood loss (1500 vs 400 ml) were significantly greater for RAC-IVCT versus RAT-IVCT (both p < 0.001). IVC invasion was a risk factor for progression-free and overall survival at midterm follow-up. Large-volume and long-term follow-up studies are needed.Conclusions: RAC-IVCT or RAT-IVCT represents an alternative minimally invasive approach for selected RCC patients with level II IVCT. Selection of RAC-IVCT or RAT-IVCT is mainly based on preoperative IVCT imaging characteristics, including the presence of IVC wall invasion, the affected kidney, and establishment of the collateral circulation.Patient summary: In this study we found that robotic surgeries for level II inferior vena cava thrombus were feasible and safe. Preoperative imaging played an important role in establishing an appropriate surgical plan. Robotics Laparoscopy Nephrectomy Renal cell carcinoma Thrombus Inferior vena cava Vascular resection Huang, Qingbo verfasserin aut Liu, Kan verfasserin aut Du, Songliang verfasserin aut Fan, Yang verfasserin aut Yang, Luojia verfasserin aut Peng, Cheng verfasserin aut Shen, Dan verfasserin aut Wang, Zhongxin verfasserin aut Gao, Yu verfasserin aut Gu, Liangyou verfasserin aut Niu, Shaoxi verfasserin aut Ai, Qing verfasserin aut Li, Hongzhao verfasserin aut Liu, Fengyong verfasserin aut Li, Qiuyang verfasserin aut Wang, Haiyi verfasserin (orcid)0000-0002-0717-1748 aut Guo, Aitao verfasserin aut Fu, Bin verfasserin aut Yang, Xiaojian verfasserin aut Zhang, Xuepei verfasserin aut Wang, Delin verfasserin aut Wang, Dongwen verfasserin aut Guo, Hongqian verfasserin aut Li, Hengping verfasserin aut Olivero, Alberto verfasserin aut Fam, Xeng Inn verfasserin aut Ma, Xin verfasserin aut Wang, Baojun verfasserin aut Zhang, Xu verfasserin aut Enthalten in European urology Amsterdam [u.a.] : Elsevier Science, 1976 78, Seite 592-602 Online-Ressource (DE-627)300191596 (DE-600)1482253-2 (DE-576)099718103 1873-7560 nnns volume:78 pages:592-602 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.88 Urologie Nephrologie AR 78 592-602 |
| allfieldsGer |
10.1016/j.eururo.2020.03.020 doi (DE-627)ELV004677021 (ELSEVIER)S0302-2838(20)30195-0 DE-627 ger DE-627 rda eng 610 DE-600 44.88 bkl Shi, Taoping verfasserin aut Robot-assisted Cavectomy Versus Thrombectomy for Level II Inferior Vena Cava Thrombus: Decision-making Scheme and Multi-institutional Analysis 2020 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Robot-assisted thrombectomy (RAT) for inferior vena cava (IVC) thrombus (RAT-IVCT) is being increasingly reported. However, the techniques and indications for robot-assisted cavectomy (RAC) for IVC thrombus are not well described.Objective: To develop a decision-making program and analyze multi-institutional outcomes of RAC-IVCT versus RAT-IVCT.Design, setting, and participants: Ninety patients with renal cell carcinoma (RCC) with level II IVCT were included from eight Chinese urological centers, and underwent RAC-IVCT (30 patients) or RAT-IVCT (60 patients) from June 2013 to January 2019.Surgical procedure: The surgical strategy was based on IVCT imaging characteristics. RAT-IVCT was performed with standardized cavotomy, thrombectomy, and IVC reconstruction. RAC-IVCT was mainly performed in patients with extensive IVC wall invasion when the collateral blood vessels were well-established. For right-sided RCC, the IVC from the infrarenal vein to the infrahepatic veins was stapled. For left-sided RCC, the IVC from the suprarenal vein to the infrahepatic veins was removed and caudal IVC reconstruction was performed to ensure the right renal vein returned through the IVC collaterals.Measurements: Clinicopathological, operative, and survival outcomes were collected and analyzed.Results and limitations: All procedures were successfully performed without open conversion. The median operation time (268 vs 190 min) and estimated blood loss (1500 vs 400 ml) were significantly greater for RAC-IVCT versus RAT-IVCT (both p < 0.001). IVC invasion was a risk factor for progression-free and overall survival at midterm follow-up. Large-volume and long-term follow-up studies are needed.Conclusions: RAC-IVCT or RAT-IVCT represents an alternative minimally invasive approach for selected RCC patients with level II IVCT. Selection of RAC-IVCT or RAT-IVCT is mainly based on preoperative IVCT imaging characteristics, including the presence of IVC wall invasion, the affected kidney, and establishment of the collateral circulation.Patient summary: In this study we found that robotic surgeries for level II inferior vena cava thrombus were feasible and safe. Preoperative imaging played an important role in establishing an appropriate surgical plan. Robotics Laparoscopy Nephrectomy Renal cell carcinoma Thrombus Inferior vena cava Vascular resection Huang, Qingbo verfasserin aut Liu, Kan verfasserin aut Du, Songliang verfasserin aut Fan, Yang verfasserin aut Yang, Luojia verfasserin aut Peng, Cheng verfasserin aut Shen, Dan verfasserin aut Wang, Zhongxin verfasserin aut Gao, Yu verfasserin aut Gu, Liangyou verfasserin aut Niu, Shaoxi verfasserin aut Ai, Qing verfasserin aut Li, Hongzhao verfasserin aut Liu, Fengyong verfasserin aut Li, Qiuyang verfasserin aut Wang, Haiyi verfasserin (orcid)0000-0002-0717-1748 aut Guo, Aitao verfasserin aut Fu, Bin verfasserin aut Yang, Xiaojian verfasserin aut Zhang, Xuepei verfasserin aut Wang, Delin verfasserin aut Wang, Dongwen verfasserin aut Guo, Hongqian verfasserin aut Li, Hengping verfasserin aut Olivero, Alberto verfasserin aut Fam, Xeng Inn verfasserin aut Ma, Xin verfasserin aut Wang, Baojun verfasserin aut Zhang, Xu verfasserin aut Enthalten in European urology Amsterdam [u.a.] : Elsevier Science, 1976 78, Seite 592-602 Online-Ressource (DE-627)300191596 (DE-600)1482253-2 (DE-576)099718103 1873-7560 nnns volume:78 pages:592-602 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.88 Urologie Nephrologie AR 78 592-602 |
| allfieldsSound |
10.1016/j.eururo.2020.03.020 doi (DE-627)ELV004677021 (ELSEVIER)S0302-2838(20)30195-0 DE-627 ger DE-627 rda eng 610 DE-600 44.88 bkl Shi, Taoping verfasserin aut Robot-assisted Cavectomy Versus Thrombectomy for Level II Inferior Vena Cava Thrombus: Decision-making Scheme and Multi-institutional Analysis 2020 nicht spezifiziert zzz rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Background: Robot-assisted thrombectomy (RAT) for inferior vena cava (IVC) thrombus (RAT-IVCT) is being increasingly reported. However, the techniques and indications for robot-assisted cavectomy (RAC) for IVC thrombus are not well described.Objective: To develop a decision-making program and analyze multi-institutional outcomes of RAC-IVCT versus RAT-IVCT.Design, setting, and participants: Ninety patients with renal cell carcinoma (RCC) with level II IVCT were included from eight Chinese urological centers, and underwent RAC-IVCT (30 patients) or RAT-IVCT (60 patients) from June 2013 to January 2019.Surgical procedure: The surgical strategy was based on IVCT imaging characteristics. RAT-IVCT was performed with standardized cavotomy, thrombectomy, and IVC reconstruction. RAC-IVCT was mainly performed in patients with extensive IVC wall invasion when the collateral blood vessels were well-established. For right-sided RCC, the IVC from the infrarenal vein to the infrahepatic veins was stapled. For left-sided RCC, the IVC from the suprarenal vein to the infrahepatic veins was removed and caudal IVC reconstruction was performed to ensure the right renal vein returned through the IVC collaterals.Measurements: Clinicopathological, operative, and survival outcomes were collected and analyzed.Results and limitations: All procedures were successfully performed without open conversion. The median operation time (268 vs 190 min) and estimated blood loss (1500 vs 400 ml) were significantly greater for RAC-IVCT versus RAT-IVCT (both p < 0.001). IVC invasion was a risk factor for progression-free and overall survival at midterm follow-up. Large-volume and long-term follow-up studies are needed.Conclusions: RAC-IVCT or RAT-IVCT represents an alternative minimally invasive approach for selected RCC patients with level II IVCT. Selection of RAC-IVCT or RAT-IVCT is mainly based on preoperative IVCT imaging characteristics, including the presence of IVC wall invasion, the affected kidney, and establishment of the collateral circulation.Patient summary: In this study we found that robotic surgeries for level II inferior vena cava thrombus were feasible and safe. Preoperative imaging played an important role in establishing an appropriate surgical plan. Robotics Laparoscopy Nephrectomy Renal cell carcinoma Thrombus Inferior vena cava Vascular resection Huang, Qingbo verfasserin aut Liu, Kan verfasserin aut Du, Songliang verfasserin aut Fan, Yang verfasserin aut Yang, Luojia verfasserin aut Peng, Cheng verfasserin aut Shen, Dan verfasserin aut Wang, Zhongxin verfasserin aut Gao, Yu verfasserin aut Gu, Liangyou verfasserin aut Niu, Shaoxi verfasserin aut Ai, Qing verfasserin aut Li, Hongzhao verfasserin aut Liu, Fengyong verfasserin aut Li, Qiuyang verfasserin aut Wang, Haiyi verfasserin (orcid)0000-0002-0717-1748 aut Guo, Aitao verfasserin aut Fu, Bin verfasserin aut Yang, Xiaojian verfasserin aut Zhang, Xuepei verfasserin aut Wang, Delin verfasserin aut Wang, Dongwen verfasserin aut Guo, Hongqian verfasserin aut Li, Hengping verfasserin aut Olivero, Alberto verfasserin aut Fam, Xeng Inn verfasserin aut Ma, Xin verfasserin aut Wang, Baojun verfasserin aut Zhang, Xu verfasserin aut Enthalten in European urology Amsterdam [u.a.] : Elsevier Science, 1976 78, Seite 592-602 Online-Ressource (DE-627)300191596 (DE-600)1482253-2 (DE-576)099718103 1873-7560 nnns volume:78 pages:592-602 GBV_USEFLAG_U SYSFLAG_U GBV_ELV SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2031 GBV_ILN_2034 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2049 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2059 GBV_ILN_2061 GBV_ILN_2064 GBV_ILN_2065 GBV_ILN_2068 GBV_ILN_2088 GBV_ILN_2106 GBV_ILN_2110 GBV_ILN_2111 GBV_ILN_2112 GBV_ILN_2113 GBV_ILN_2118 GBV_ILN_2122 GBV_ILN_2129 GBV_ILN_2143 GBV_ILN_2147 GBV_ILN_2148 GBV_ILN_2152 GBV_ILN_2153 GBV_ILN_2190 GBV_ILN_2232 GBV_ILN_2336 GBV_ILN_2470 GBV_ILN_2507 GBV_ILN_2522 GBV_ILN_2548 GBV_ILN_4035 GBV_ILN_4037 GBV_ILN_4046 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4242 GBV_ILN_4249 GBV_ILN_4251 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4326 GBV_ILN_4333 GBV_ILN_4334 GBV_ILN_4335 GBV_ILN_4338 GBV_ILN_4393 44.88 Urologie Nephrologie AR 78 592-602 |
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Enthalten in European urology 78, Seite 592-602 volume:78 pages:592-602 |
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Robotics Laparoscopy Nephrectomy Renal cell carcinoma Thrombus Inferior vena cava Vascular resection |
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Shi, Taoping @@aut@@ Huang, Qingbo @@aut@@ Liu, Kan @@aut@@ Du, Songliang @@aut@@ Fan, Yang @@aut@@ Yang, Luojia @@aut@@ Peng, Cheng @@aut@@ Shen, Dan @@aut@@ Wang, Zhongxin @@aut@@ Gao, Yu @@aut@@ Gu, Liangyou @@aut@@ Niu, Shaoxi @@aut@@ Ai, Qing @@aut@@ Li, Hongzhao @@aut@@ Liu, Fengyong @@aut@@ Li, Qiuyang @@aut@@ Wang, Haiyi @@aut@@ Guo, Aitao @@aut@@ Fu, Bin @@aut@@ Yang, Xiaojian @@aut@@ Zhang, Xuepei @@aut@@ Wang, Delin @@aut@@ Wang, Dongwen @@aut@@ Guo, Hongqian @@aut@@ Li, Hengping @@aut@@ Olivero, Alberto @@aut@@ Fam, Xeng Inn @@aut@@ Ma, Xin @@aut@@ Wang, Baojun @@aut@@ Zhang, Xu @@aut@@ |
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2020-01-01T00:00:00Z |
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<?xml version="1.0" encoding="UTF-8"?><collection xmlns="http://www.loc.gov/MARC21/slim"><record><leader>01000caa a22002652 4500</leader><controlfield tag="001">ELV004677021</controlfield><controlfield tag="003">DE-627</controlfield><controlfield tag="005">20230524162039.0</controlfield><controlfield tag="007">cr uuu---uuuuu</controlfield><controlfield tag="008">230503s2020 xx |||||o 00| ||eng c</controlfield><datafield tag="024" ind1="7" ind2=" "><subfield code="a">10.1016/j.eururo.2020.03.020</subfield><subfield code="2">doi</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(DE-627)ELV004677021</subfield></datafield><datafield tag="035" ind1=" " ind2=" "><subfield code="a">(ELSEVIER)S0302-2838(20)30195-0</subfield></datafield><datafield tag="040" ind1=" " ind2=" "><subfield code="a">DE-627</subfield><subfield code="b">ger</subfield><subfield code="c">DE-627</subfield><subfield code="e">rda</subfield></datafield><datafield tag="041" ind1=" " ind2=" "><subfield code="a">eng</subfield></datafield><datafield tag="082" ind1="0" ind2="4"><subfield code="a">610</subfield><subfield code="q">DE-600</subfield></datafield><datafield tag="084" ind1=" " ind2=" "><subfield code="a">44.88</subfield><subfield code="2">bkl</subfield></datafield><datafield tag="100" ind1="1" ind2=" "><subfield code="a">Shi, Taoping</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="245" ind1="1" ind2="0"><subfield code="a">Robot-assisted Cavectomy Versus Thrombectomy for Level II Inferior Vena Cava Thrombus: Decision-making Scheme and Multi-institutional Analysis</subfield></datafield><datafield tag="264" ind1=" " ind2="1"><subfield code="c">2020</subfield></datafield><datafield tag="336" ind1=" " ind2=" "><subfield code="a">nicht spezifiziert</subfield><subfield code="b">zzz</subfield><subfield code="2">rdacontent</subfield></datafield><datafield tag="337" ind1=" " ind2=" "><subfield code="a">Computermedien</subfield><subfield code="b">c</subfield><subfield code="2">rdamedia</subfield></datafield><datafield tag="338" ind1=" " ind2=" "><subfield code="a">Online-Ressource</subfield><subfield code="b">cr</subfield><subfield code="2">rdacarrier</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Background: Robot-assisted thrombectomy (RAT) for inferior vena cava (IVC) thrombus (RAT-IVCT) is being increasingly reported. However, the techniques and indications for robot-assisted cavectomy (RAC) for IVC thrombus are not well described.Objective: To develop a decision-making program and analyze multi-institutional outcomes of RAC-IVCT versus RAT-IVCT.Design, setting, and participants: Ninety patients with renal cell carcinoma (RCC) with level II IVCT were included from eight Chinese urological centers, and underwent RAC-IVCT (30 patients) or RAT-IVCT (60 patients) from June 2013 to January 2019.Surgical procedure: The surgical strategy was based on IVCT imaging characteristics. RAT-IVCT was performed with standardized cavotomy, thrombectomy, and IVC reconstruction. RAC-IVCT was mainly performed in patients with extensive IVC wall invasion when the collateral blood vessels were well-established. For right-sided RCC, the IVC from the infrarenal vein to the infrahepatic veins was stapled. For left-sided RCC, the IVC from the suprarenal vein to the infrahepatic veins was removed and caudal IVC reconstruction was performed to ensure the right renal vein returned through the IVC collaterals.Measurements: Clinicopathological, operative, and survival outcomes were collected and analyzed.Results and limitations: All procedures were successfully performed without open conversion. The median operation time (268 vs 190 min) and estimated blood loss (1500 vs 400 ml) were significantly greater for RAC-IVCT versus RAT-IVCT (both p < 0.001). IVC invasion was a risk factor for progression-free and overall survival at midterm follow-up. Large-volume and long-term follow-up studies are needed.Conclusions: RAC-IVCT or RAT-IVCT represents an alternative minimally invasive approach for selected RCC patients with level II IVCT. Selection of RAC-IVCT or RAT-IVCT is mainly based on preoperative IVCT imaging characteristics, including the presence of IVC wall invasion, the affected kidney, and establishment of the collateral circulation.Patient summary: In this study we found that robotic surgeries for level II inferior vena cava thrombus were feasible and safe. 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Shi, Taoping |
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Shi, Taoping ddc 610 bkl 44.88 misc Robotics misc Laparoscopy misc Nephrectomy misc Renal cell carcinoma misc Thrombus misc Inferior vena cava misc Vascular resection Robot-assisted Cavectomy Versus Thrombectomy for Level II Inferior Vena Cava Thrombus: Decision-making Scheme and Multi-institutional Analysis |
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610 DE-600 44.88 bkl Robot-assisted Cavectomy Versus Thrombectomy for Level II Inferior Vena Cava Thrombus: Decision-making Scheme and Multi-institutional Analysis Robotics Laparoscopy Nephrectomy Renal cell carcinoma Thrombus Inferior vena cava Vascular resection |
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ddc 610 bkl 44.88 misc Robotics misc Laparoscopy misc Nephrectomy misc Renal cell carcinoma misc Thrombus misc Inferior vena cava misc Vascular resection |
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ddc 610 bkl 44.88 misc Robotics misc Laparoscopy misc Nephrectomy misc Renal cell carcinoma misc Thrombus misc Inferior vena cava misc Vascular resection |
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ddc 610 bkl 44.88 misc Robotics misc Laparoscopy misc Nephrectomy misc Renal cell carcinoma misc Thrombus misc Inferior vena cava misc Vascular resection |
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Robot-assisted Cavectomy Versus Thrombectomy for Level II Inferior Vena Cava Thrombus: Decision-making Scheme and Multi-institutional Analysis |
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Robot-assisted Cavectomy Versus Thrombectomy for Level II Inferior Vena Cava Thrombus: Decision-making Scheme and Multi-institutional Analysis |
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Shi, Taoping |
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Shi, Taoping Huang, Qingbo Liu, Kan Du, Songliang Fan, Yang Yang, Luojia Peng, Cheng Shen, Dan Wang, Zhongxin Gao, Yu Gu, Liangyou Niu, Shaoxi Ai, Qing Li, Hongzhao Liu, Fengyong Li, Qiuyang Wang, Haiyi Guo, Aitao Fu, Bin Yang, Xiaojian Zhang, Xuepei Wang, Delin Wang, Dongwen Guo, Hongqian Li, Hengping Olivero, Alberto Fam, Xeng Inn Ma, Xin Wang, Baojun Zhang, Xu |
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10.1016/j.eururo.2020.03.020 |
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robot-assisted cavectomy versus thrombectomy for level ii inferior vena cava thrombus: decision-making scheme and multi-institutional analysis |
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Robot-assisted Cavectomy Versus Thrombectomy for Level II Inferior Vena Cava Thrombus: Decision-making Scheme and Multi-institutional Analysis |
| abstract |
Background: Robot-assisted thrombectomy (RAT) for inferior vena cava (IVC) thrombus (RAT-IVCT) is being increasingly reported. However, the techniques and indications for robot-assisted cavectomy (RAC) for IVC thrombus are not well described.Objective: To develop a decision-making program and analyze multi-institutional outcomes of RAC-IVCT versus RAT-IVCT.Design, setting, and participants: Ninety patients with renal cell carcinoma (RCC) with level II IVCT were included from eight Chinese urological centers, and underwent RAC-IVCT (30 patients) or RAT-IVCT (60 patients) from June 2013 to January 2019.Surgical procedure: The surgical strategy was based on IVCT imaging characteristics. RAT-IVCT was performed with standardized cavotomy, thrombectomy, and IVC reconstruction. RAC-IVCT was mainly performed in patients with extensive IVC wall invasion when the collateral blood vessels were well-established. For right-sided RCC, the IVC from the infrarenal vein to the infrahepatic veins was stapled. For left-sided RCC, the IVC from the suprarenal vein to the infrahepatic veins was removed and caudal IVC reconstruction was performed to ensure the right renal vein returned through the IVC collaterals.Measurements: Clinicopathological, operative, and survival outcomes were collected and analyzed.Results and limitations: All procedures were successfully performed without open conversion. The median operation time (268 vs 190 min) and estimated blood loss (1500 vs 400 ml) were significantly greater for RAC-IVCT versus RAT-IVCT (both p < 0.001). IVC invasion was a risk factor for progression-free and overall survival at midterm follow-up. Large-volume and long-term follow-up studies are needed.Conclusions: RAC-IVCT or RAT-IVCT represents an alternative minimally invasive approach for selected RCC patients with level II IVCT. Selection of RAC-IVCT or RAT-IVCT is mainly based on preoperative IVCT imaging characteristics, including the presence of IVC wall invasion, the affected kidney, and establishment of the collateral circulation.Patient summary: In this study we found that robotic surgeries for level II inferior vena cava thrombus were feasible and safe. Preoperative imaging played an important role in establishing an appropriate surgical plan. |
| abstractGer |
Background: Robot-assisted thrombectomy (RAT) for inferior vena cava (IVC) thrombus (RAT-IVCT) is being increasingly reported. However, the techniques and indications for robot-assisted cavectomy (RAC) for IVC thrombus are not well described.Objective: To develop a decision-making program and analyze multi-institutional outcomes of RAC-IVCT versus RAT-IVCT.Design, setting, and participants: Ninety patients with renal cell carcinoma (RCC) with level II IVCT were included from eight Chinese urological centers, and underwent RAC-IVCT (30 patients) or RAT-IVCT (60 patients) from June 2013 to January 2019.Surgical procedure: The surgical strategy was based on IVCT imaging characteristics. RAT-IVCT was performed with standardized cavotomy, thrombectomy, and IVC reconstruction. RAC-IVCT was mainly performed in patients with extensive IVC wall invasion when the collateral blood vessels were well-established. For right-sided RCC, the IVC from the infrarenal vein to the infrahepatic veins was stapled. For left-sided RCC, the IVC from the suprarenal vein to the infrahepatic veins was removed and caudal IVC reconstruction was performed to ensure the right renal vein returned through the IVC collaterals.Measurements: Clinicopathological, operative, and survival outcomes were collected and analyzed.Results and limitations: All procedures were successfully performed without open conversion. The median operation time (268 vs 190 min) and estimated blood loss (1500 vs 400 ml) were significantly greater for RAC-IVCT versus RAT-IVCT (both p < 0.001). IVC invasion was a risk factor for progression-free and overall survival at midterm follow-up. Large-volume and long-term follow-up studies are needed.Conclusions: RAC-IVCT or RAT-IVCT represents an alternative minimally invasive approach for selected RCC patients with level II IVCT. Selection of RAC-IVCT or RAT-IVCT is mainly based on preoperative IVCT imaging characteristics, including the presence of IVC wall invasion, the affected kidney, and establishment of the collateral circulation.Patient summary: In this study we found that robotic surgeries for level II inferior vena cava thrombus were feasible and safe. Preoperative imaging played an important role in establishing an appropriate surgical plan. |
| abstract_unstemmed |
Background: Robot-assisted thrombectomy (RAT) for inferior vena cava (IVC) thrombus (RAT-IVCT) is being increasingly reported. However, the techniques and indications for robot-assisted cavectomy (RAC) for IVC thrombus are not well described.Objective: To develop a decision-making program and analyze multi-institutional outcomes of RAC-IVCT versus RAT-IVCT.Design, setting, and participants: Ninety patients with renal cell carcinoma (RCC) with level II IVCT were included from eight Chinese urological centers, and underwent RAC-IVCT (30 patients) or RAT-IVCT (60 patients) from June 2013 to January 2019.Surgical procedure: The surgical strategy was based on IVCT imaging characteristics. RAT-IVCT was performed with standardized cavotomy, thrombectomy, and IVC reconstruction. RAC-IVCT was mainly performed in patients with extensive IVC wall invasion when the collateral blood vessels were well-established. For right-sided RCC, the IVC from the infrarenal vein to the infrahepatic veins was stapled. For left-sided RCC, the IVC from the suprarenal vein to the infrahepatic veins was removed and caudal IVC reconstruction was performed to ensure the right renal vein returned through the IVC collaterals.Measurements: Clinicopathological, operative, and survival outcomes were collected and analyzed.Results and limitations: All procedures were successfully performed without open conversion. The median operation time (268 vs 190 min) and estimated blood loss (1500 vs 400 ml) were significantly greater for RAC-IVCT versus RAT-IVCT (both p < 0.001). IVC invasion was a risk factor for progression-free and overall survival at midterm follow-up. Large-volume and long-term follow-up studies are needed.Conclusions: RAC-IVCT or RAT-IVCT represents an alternative minimally invasive approach for selected RCC patients with level II IVCT. Selection of RAC-IVCT or RAT-IVCT is mainly based on preoperative IVCT imaging characteristics, including the presence of IVC wall invasion, the affected kidney, and establishment of the collateral circulation.Patient summary: In this study we found that robotic surgeries for level II inferior vena cava thrombus were feasible and safe. Preoperative imaging played an important role in establishing an appropriate surgical plan. |
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Robot-assisted Cavectomy Versus Thrombectomy for Level II Inferior Vena Cava Thrombus: Decision-making Scheme and Multi-institutional Analysis |
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Huang, Qingbo Liu, Kan Du, Songliang Fan, Yang Yang, Luojia Peng, Cheng Shen, Dan Wang, Zhongxin Gao, Yu Gu, Liangyou Niu, Shaoxi Ai, Qing Li, Hongzhao Liu, Fengyong Li, Qiuyang Wang, Haiyi Guo, Aitao Fu, Bin Yang, Xiaojian Zhang, Xuepei Wang, Delin Wang, Dongwen Guo, Hongqian Li, Hengping Olivero, Alberto Fam, Xeng Inn Ma, Xin Wang, Baojun Zhang, Xu |
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|
| score |
7.401063 |