Authors
Yunhe Guan, Ye Yan, Ruiyang Xie, Liyuan Ge, Xiaojun Tian, Guoliang Wang, Lulin Ma, Hongxian Zhang, Shudong Zhang
Published in
World journal of urology. Volume 44. Issue 1. Sep 06, 2026. Epub Sep 06, 2026.
Abstract
IVC segmental resection (SR) during robot-assisted radical nephrectomy and IVC thrombectomy (RARN-IVCT) is selected for wall invasion, occlusion, and collateral outflow, making direct comparison with non-segmental resection (NSR) biased. We compared the perioperative and renal safety of SR versus NSR in the overlap population.
Retrospective single-center cohort at Peking University Third Hospital (2014-2025): 120 patients with RCC and Mayo level II-IV IVC thrombus undergoing RARN-IVCT, including 45 SR and 75 NSR. Overlap weighting balanced baseline variables. Primary outcomes were AKI, ΔSCr, and ΔeGFR; secondary outcomes were complications and hospital stay, with OS assessed exploratorily.
After weighting, no statistically significant differences were observed in AKI, ΔSCr, ΔeGFR, complications, hospital stay, or OS. SR had lower RBC transfusion volume (mean difference - 249.63 mL, 95% CI - 443.20 to - 56.05; P = 0.011). SR met non-inferiority/equivalence for hospital stay and pneumonia; renal non-inferiority was not established. Limitations include retrospective design, limited effective sample size, and unmeasured anatomic/hemodynamic confounding.
In overlap patients, no statistically significant differences in renal or safety/recovery outcomes were observed, but neither renal non-inferiority nor equivalence was established. Planning should consider thrombus-wall interaction, caval patency, collateral outflow, and renal reserve.
PMID:
42701915
Bibliographic data and abstract were imported from PubMed on 07 Sep 2026.
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