Robot-Assisted Nephron-Sparing Surgery with Thrombectomy for Renal Angiomyolipoma with Venous Tumor Thrombus:A Report of 5 Cases
Chen Yibo
Jia Zhuo
Song Jialong
Liu Kan
Peng Cheng
Jiao Qilong
Su Teng
Shi Changwei
Yu Shaoqing
Zhang Xu
Ma Xin
Huang Qingbo
Abstract：Objective:To explore the safety and feasibility of robotic partial nephrectomy combined with venous thrombus extraction in the treatment of renal angiomyolipoma(RAML)complicated with venous thrombus.Methods:A ret-rospective analysis was performed on the clinical data of 5 patients with RAML complicated with venous thrombus who under-went robot-assisted nephron-sparing surgery with thrombectomy in Senior Department of Urology,PLA General Hospital be-tween June 2018 and March 2025.One patient was male and 4 were female,with a median age of 42(range:34-61)years.All renal tumors were located on the right side,with a median maximum diameter of the primary tumor of 2.1(range:0.5-5.7)cm.Venous thrombi were classified according to the"301 Classification System":1 case of grade 0,1 case of grade I,and 3 cas-es of grade II.Results:All 5 patients successfully completed the surgery without conversion to open surgery or radical ne-phrectomy.The median operation time was 145(range:95-175)minutes,median blood loss was 300(range:50-600)mL,me-dian right renal artery clamping time was 27(range:20-31)minutes,median inferior vena cava clamping time was 7(range:3-20)minutes,and median postoperative hospital stay was 5(range:4-7)days.No perioperative severe complications(Clavien-Dindo grade Ⅲ-Ⅴ)occurred in any of the 5 patients,and there was no postoperative hematuria or urinary fistula.Postopera-tive pathology confirmed RAML in all 5 patients.The renal function of the patients recovered to the baseline level at 1 day,1 month,and 3 months after surgery,and no tumor recurrence was observed during follow-up.Conclusion:This study initially verifies that robotic partial nephrectomy combined with venous thrombus extraction is safe and feasible for the treatment of RAML complicated with venous thrombus,and this surgical approach can achieve better renal function preservation.
Keywords：renal tumorvenous tumor thrombusnephron-sparing surgeryrobotic surgerylaparoscopy
Publication Date：2025-08-28
Online Publishing Date：2025-10-22(First online date of this platform, not the publication date of the document)
Pages：4( 217-220 )