Multidisciplinary Team Management Improves Safety and Survival in Robot-Assisted Nephrectomy and Inferior Vena Cava Thrombectomy: A Propensity Score-Matched Study.

PURPOSE Robot-assisted nephrectomy and inferior vena cava (IVC) thrombectomy are technically demanding and high-risk procedures. The role of multidisciplinary team (MDT) management in robotic surgeries has not been reported previously. This study aimed to evaluate the safety and feasibility of MDT management in robot-assisted nephrectomy and IVC thrombectomy. PATIENTS AND METHODS We retrospectively analyzed 209 patients who underwent robot-assisted nephrectomy and IVC thrombectomy for renal tumor with venous tumor thrombus (Mayo levels I-IV) in our center between June 2013 and December 2023. Since July 2018, a proactive, comprehensive, and full-process MDT management framework has been implemented perioperatively. Patients were divided into MDT management (n = 142) and non-MDT management (n = 67) groups, with propensity score matching (1:1) resulting in 67 patients in each group. Multivariable regression, survival analyses, and interrupted time series analysis were conducted to assess perioperative outcomes and survival. RESULTS All procedures were completed without conversion. MDT management significantly improved perioperative outcomes compared with the non-MDT group. Specifically, MDT reduced estimated blood loss (p = 0.045), intraoperative blood transfusion (p = 0.009), blood transfusion volume (p = 0.005), postoperative intensive care unit stay (p = 0.002), and postoperative hospital stay (p < 0.001). Multivariable regression confirmed that these improvements were independent of other factors. MDT management was associated with a significant improvement in overall survival (hazard ratio [HR] = 0.27, p = 0.023) and a potential benefit in progression-free survival (HR = 0.40, p = 0.065), as indicated by survival analysis. CONCLUSIONS MDT management in robot-assisted nephrectomy and IVC thrombectomy improves perioperative safety and enhances survival outcomes. This study highlights the critical role of the standardized MDT framework we proposed in optimizing high-risk robotic procedures.

• Publication year

  2026

• Venue

  Journal of endourology

• Publication date

  2026-02-09

• Fields of study

  Medicine, Engineering

• Identifiers
  DOI 10.1177/08927790261420551PMID 41657046
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar

• No claims are published for this paper.

• No concepts are published for this paper.

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