A Case Series of Six Patients With Renal Cell Carcinoma With Inferior Vena Cava Tumor Thrombus Who Underwent Robotic-Assisted Radical Nephrectomy

Abstract

Introduction

Inferior vena cava (IVC) tumor thrombus occurs in 4%–10% of renal cell carcinoma (RCC) cases. Robotic-assisted radical nephrectomy (RARN) with IVC tumor thrombectomy offers a minimally invasive alternative to open surgery.

Materials and Methods

We retrospectively reviewed six cases of RARN for RCC with IVC thrombus at two institutions between April 2022 and August 2024. For left-sided RCC, the left renal vein was transected using a vascular stapler before IVC thrombectomy, ensuring adequate access for thrombus removal.

Results

Four patients had right-sided RCC, and two had left-sided RCC. The median operative time was 256 min, with a median blood loss of 175 mL. No conversions to open surgery, positive surgical margins, or major complications (Clavien-Dindo grade ≥ 3) were reported. No blood transfusions were required.

Conclusion

RARN with IVC thrombectomy resulted in minimal blood loss and no serious complications. Our findings suggest that it is a feasible and safe procedure, even when performed with technical modifications for left-sided RCC.