In a study from the University of Texas Health Science Center at San Antonio, robotic kidney cancer surgery was found to have favourable results.
Cancer of the kidney is not usually restricted to the kidney. In late stages, this malignancy invades the largest vein in the body, the inferior vena cava (IVC), which returns blood from the kidneys to the heart. Cancer may invade the liver and heart via the IVC. The Mays Cancer Center at The University of Texas Health Science Center at San Antonio (UT Health San Antonio) is one of the high-volume U.S. centres with surgical expertise in the treatment of this significant issue. The National Cancer Institute has recognised the Mays Cancer Center as San Antonio’s cancer centre.
In a study featured on the cover of the Journal of Urology (Official Journal of the American Urological Association), researchers from the Mays Cancer Center and Department of Urology at UT Health San Antonio demonstrate that robotic IVC thrombectomy (removal of cancer from the inferior vena cava) is not inferior to conventional open IVC thrombectomy and is a highly safe and effective alternative technique. During surgery done at University Hospital, a clinical partner of UT Health San Antonio, both the damaged kidney and the tumour are removed.
The study’s first author is Harshit Garg, MD, a urologic oncology fellow at the Department of Urology, and the senior author is Dharashik Kaushik, MD, director of the urologic oncology fellowship programme. Kaushik is an associate professor at UT Health San Antonio and holds the Stanley and Sandra Rosenberg Endowed Chair in Urologic Research.
The incision for the open operation begins 2 inches below the ribcage and extends down both sides of the ribcage. “It looks like an inverted V,” Kaushik added. After mobilising organs that surround the IVC, such as the liver, the IVC is constricted above and below the malignancy. Surgeons obtain control of the inferior vena cava for tumour removal in this manner.
The study is a systematic review and meta-analysis of data from 28 studies in which 1,375 patients from various medical centres participated. 439 of these patients underwent robotic IVC thrombectomy, whereas 936 have open surgery. Kaushik and his team conducted this study in conjunction with Memorial Sloan Kettering Cancer Center in New York, Cedars-Sinai Medical Center in Los Angeles, and the University of Washington in Seattle.
Findings
The results are encouraging and indicate that additional research into robotic IVC thrombectomy is necessary. Compared to open, the robotic method was related with:
18% of robotic patients required blood transfusions, while 64% of open patients did.
5 percent of robotic patients suffered issues like bleeding, compared to 36.7 percent of conventional thrombectomy patients.
A multidisciplinary team of vascular surgeons, heart surgeons, transplant surgeons, and urologic oncology surgeons performs these lengthy, technically difficult procedures, which take eight to ten hours, according to Kaushik.
This is the greatest meta-analysis comparing the outcomes of robotic and open IVC thrombectomy, according to Kaushik. “In more than 1,300 patients, we discovered that overall problems were reduced with the robotic method, as was the rate of blood transfusions.