Hepatic caudate lobectomy in robot-assisted inferior vena cava tumor thrombectomy:single-center experience
Peng Cheng
Song Jialong
Zhao Guodong
Liu Kan
Xu Liang
Jia Zhuo
Li Zhi
Li Xiaohang
Li Shichao
Wang Baojun
Zhang Xu
Ma Xin
Huang Qingbo
Abstract：Objective:To explore the feasibility and effectiveness of robot-assisted inferior vena cava tumor thrombectomy combined with hepatic caudate lobectomy for patients with level Ⅱ-Ⅲ(301 classification)inferior ve-na cava tumor thrombus.Methods:The clinical data of 5 patients who underwent robot-assisted inferior vena cava tu-mor thrombectomy in the First Medical Center of PLA General Hospital from January 2021 to June 2022 were retro-spectively analyzed.All of the 5 patients underwent partial hepatic caudate lobectomy during the surgeries to expose the retrohepatic inferior vena cava.There were 2 males and 3 females with a median age of 61(60-75)years,the medi-an body mass index was 24.8(21.7-25.3)kg/m2.According to 301 classification,there were 1 patient with level Ⅱ tu-mor thrombus,and 4 patients with level Ⅲ tumor thrombus.The median height of inferior vena cava tumor thrombus was 10.8(10.4-13.1)cm,and the maximum median diameter of tumor thrombus was 2.0(1.5-3.9)cm.Results:All the 5 operations were successfully completed without conversion.The median operative time was 510(290-795)min,and the median estimated blood loss was 1 500(900-2 000)ml.The median length of postoperative intensive care unit(ICU)stay was 4(0-7)d,and the median postoperative hospital stay was 11(6-13)d.There were 2 cases of gradeⅠ complications,3 cases of grade Ⅱ complications,and no perioperative death.At the time of discharge,the liver and kidney function of the 5 patients had decreased to the baseline level.The median follow-up time was 8.3(2.5-16.1)months,and there was no tumor recurrence,progression,or metastasis.Conclusion:For patients with renal tumors accompanied by large inferior vena cava tumor thrombi closely adjacent to the second hepatic hilum,intraoper-ative resection of the caudate lobe allows better exposure of the retrohepatic segment of the inferior vena cava,facili-tating early intraoperative control of the proximal end of the inferior vena cava tumor thrombus and thereby improving surgical safety.
Keywords：renal neoplasmsinferior vena cava tumor thrombushepatic caudate loberobotlaparoscopy
Publication Date：2024-08-05
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 229-234 )