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Updated: Jun 5, 2026
Robot-Assisted Kidney Transplantation
Published on: July 19, 2021
Comparative Outcomes of Robot-assisted versus Open Radical Nephrectomy with IVC Thrombectomy in France: Insights from
Jean Tournant1, Gaëlle Margue2, Franck Bruyere3
1Bordeaux University Hospital, Urology department, Bordeaux, France; I.CaRe Bordeaux - BRIC Inserm, UMR1312, Bordeaux Institute of Oncology, Bordeaux University, Bordeaux, France.
Background:
While robotic-assisted radical nephrectomy with IVC thrombectomy (R-CT) has emerged as a minimally invasive alternative to the open approach (O-CT), the latter remains the standard, with limited comparative studies.
Objective:
This study aimed to compare perioperative outcomes and oncological efficacy of R-CT versus O-CT based on the French multicenter experience.
Design, Setting, And Participants:
We conducted a retrospective, multicenter, propensity score-matched study using prospectively collected data from the UroCCR kidney cancer research network. Patients with Mayo level 1-2 thrombus who underwent O-CT or R-CT between December 2015 and July 2024 in eight tertiary centers were included.
Intervention:
Open or robotic-assisted radical nephrectomy with IVC thrombectomy.
Outcome Measurements And Statistical Analysis:
Propensity scores were estimated through a logistic model including demographic, clinical, and tumor-related variables. Matching was performed using optimal full matching and a 0.2 SD caliper. Treatment effects were estimated using linear, logistic, or Cox regression models and pooled across imputations according to Rubin's rules. The primary outcome was surgical morbidity, while secondary outcomes included surgical, oncological and functional outcomes.
Results And Limitations:
After matching, 92 of the 94 included patients remained, including 57 open and 35 robotic cases. Lower estimated blood loss (median, 400 mL vs. 1300 mL; p=0.013) and global length of stay (median, 5 days vs. 8 days; p=0.008) were observed in the robotic group. There were no statistically significant differences in complications, oncological and functional outcomes.
Conclusions:
In selected patients and expert centers, R-CT was associated with reduced blood loss and faster recovery compared to O-CT.
Patient Summary:
We compared two surgical techniques to remove kidney tumors that extend into the IVC. The robotic approach was associated with less blood loss and shorter hospital stays. Cancer control and kidney function were similar between both techniques.
