Robotic renal and adrenal oncologic surgery: A contemporary review

Bhat, Kulthe Ramesh Seetharam; Moschovas, Marcio Covas; Önol, Fikret Fatih; Rogers, Travis; Roof, Shannon; Patel, Vipul; Schatloff, Oscar

doi:10.1016/j.ajur.2020.05.010

Cited by 6 publications

(3 citation statements)

References 92 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Preoperative planning helps determine the success of the RARN/IVCTT, a complicated procedure. Crucial factors to obtain from preoperative imaging include the proximal extent of the thrombus, size of the primary tumor, lymph node status, volume of the thrombus, distance from the hepatic veins, arterialization, and potential caval wall invasion [ 47 , 48 ]. IVC tumor thrombi have the potential to grow rapidly, so it is recommended that imaging be performed or repeated within 1 to 2 weeks of the surgery for precise surgical planning [ 29 ].…”

Section: Resultsmentioning

confidence: 99%

A Narrative Review on Robotic Surgery as Treatment for Renal Cell Carcinoma with Inferior Vena Cava Thrombus

Shah,

Wang,

Shah

et al. 2024

JCM

View full text Add to dashboard Cite

Renal cell carcinoma (RCC) is a common diagnosis, of which a notable portion of patients present with an extension into the venous circulation causing an inferior vena cava (IVC) tumor thrombus. Venous extension has significant implications for staging and subsequent treatment planning, with recommendations for more aggressive surgical removal, although associated surgical morbidity and mortality is relatively increased. The methods for surgical removal of RCC with IVC thrombus remain complex, particularly surrounding the use of robot-assisted surgery. Robot assistance for radical nephrectomy in this context is recently emerging. Thrombus level has important implications for surgical technique and prognosis. Other preoperative considerations may include location, laterality, size, and wall invasion. The urology literature on treatment of such tumors is largely limited to case series and institutional studies that describe the feasibility of various surgical options for these complex tumors. Further understanding of the outcomes and patient-specific risk factors would shed increased light on the optimal treatment for such cases. This narrative review provides a thorough overview on the previously reported use of robot-assisted nephrectomy in RCC with IVC thrombus to inform further studies which may optimize outcomes and guide shared decision-making.

show abstract

Section: Resultsmentioning

confidence: 99%

A Narrative Review on Robotic Surgery as Treatment for Renal Cell Carcinoma with Inferior Vena Cava Thrombus

Shah,

Wang,

Shah

et al. 2024

JCM

View full text Add to dashboard Cite

show abstract

“…The indications of RALPN gradually expanded to include complex renal tumors, such as renal hilar and endophytic tumors. Hilar tumors have long been a challenge for surgeons to perform minimally invasive surgery due to their difficult placement 9–12 . Although relevant literature has demonstrated the feasibility and safety of CLPN and RALPN in the treatment of hilar tumors, only surgeons with extensive laparoscopic experience can do CLPN 13,14 .…”

Section: Introductionmentioning

confidence: 99%

Robot‐assisted versus conventional laparoscopic partial nephrectomy for renal hilar tumors: Parenchymal preservation and functional recovery

et al. 2022

View full text Add to dashboard Cite

Objective To determine whether robot‐assisted laparoscopic partial nephrectomy (RALPN) can benefit patients in terms of functional recovery in the treatment of renal hilar tumors compared to conventional laparoscopic partial nephrectomy (CLPN). Methods Between January 2019 and July 2021, patients with hilar tumors who underwent partial nephrectomy (PN) were acquired at our center and were classified into RALPN and CLPN groups. Ipsilateral parenchymal volume (IPV) and glomerular filtration rate (GFR) were determined independently 3–5 days before and 3 months after PN using contrast‐enhanced computed tomography and nuclear renal scans. Pearson correlation was used to determine the link between ipsilateral GFR preservation and IPV preserved. Concurrently, multivariable analysis was employed to determine characteristics associated with functional recovery. Results A total of 96 patients with hilar tumors were studied, of which 41 received RALPN and 55 received CLPN. Excisional parenchymal volume was 27 and 37 cm3 (p = 0.005) in RALPN and CLPN groups, respectively, and IPV preserved was 77% and 68% (p < 0.001). Furthermore, the ipsilateral GFR preserved was 77.7% and 75.3%, respectively (p = 0.003). On Pearson correlation, ipsilateral GFR preservation was linked with IPV preserved (r = 0.36, p < 0.001). According to a multivariate study, baseline GFR, IPV preserved, and surgical procedures (RALPN vs. CLPN) were significant factors influencing functional recovery. Conclusion Our study suggests that RALPN, rather than CLPN, can achieve better functional recovery in the treatment of hilar tumors due to its ability to win more IPV preserved. RALPN should be recommended as the first‐line treatment for hilar tumors, but randomized controlled trials are required to validate our findings.

show abstract

“…However, in a systematic review of 14 retrospective studies, Lardas et al ., concluded that surgical management of patients with non‐metastatic RCC with IVC thrombus is complex, but potentially curative and acceptable 1 . Surgical procedures in RA‐RN/IVCTT vary depending on the level of thrombus; recently, Seetharam et al ., reported that RA‐RN/IVCTT is feasible and safe for level I, II, and III thrombus in high volume centers 2 . Due to the high levels of surgical complexity and variation, RA‐RN/IVCTT is currently performed solely by well‐experienced surgeons in limited high‐volume centers, and its safety is still unknown.…”

mentioning

confidence: 99%

Robotic renal and adrenal oncologic surgery: A contemporary review

Cited by 6 publications

References 92 publications

A Narrative Review on Robotic Surgery as Treatment for Renal Cell Carcinoma with Inferior Vena Cava Thrombus

A Narrative Review on Robotic Surgery as Treatment for Renal Cell Carcinoma with Inferior Vena Cava Thrombus

Robot‐assisted versus conventional laparoscopic partial nephrectomy for renal hilar tumors: Parenchymal preservation and functional recovery

Editorial Comment to Robot‐assisted radical nephrectomy and inferior vena cava tumor thrombectomy: Initial experience in Japan

Contact Info

Product

Resources

About