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Journal of Peking University (Health Sciences) ›› 2026, Vol. 58 ›› Issue (4): 716-722. doi: 10.19723/j.issn.1671-167X.2026.04.006

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Preliminary clinical experience of domestic robot-assisted laparoscopic radical nephrectomy with venous tumor thrombectomy

Zhuo LIU, Shuai LIU, Guoliang WANG, Xiaojun TIAN, Hongxian Zhang, Lei LIU, Lulin MA*(), Shudong ZHANG*()   

  1. Department of Urology, Peking University Third Hospital, Beijing 100191, China
  • Received:2026-02-27 Online:2026-08-18 Published:2026-05-15
  • Contact: Lulin MA, Shudong ZHANG
  • Supported by:
    the National Natural Science Foundation of China(82473287); the Peking University Third Hospital Clinical Cohort Construction Project(BYSYDL2025031)

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Abstract:

Objective: To preliminarily investigate the safety and feasibility of domestic Jingfeng MP1000 multi-port robotic surgical system-assisted laparoscopic radical nephrectomy with venous tumor thrombectomy. Methods: Clinical data of 15 patients with renal cell carcinoma (RCC) and venous tumor thrombus who underwent Jingfeng MP1000 robot-assisted laparoscopic radical nephrectomy with venous tumor thrombectomy at the Department of Urology, Peking University Third Hospital from June 2024 to January 2026 were retrospectively analyzed. The primary outcomes were the success rate of the robotic procedure, overall complication rate, and major complication rate (Clavien-Dindo ≥ grade Ⅲ). Secondary outcomes included operative time, estimated blood loss, and length of hospital stay. Baseline characteristics, perioperative outcomes, pathological results, and postoperative complications were collected and analyzed using descriptive statistical methods. Results: All the 15 procedures were successfully completed with robotic assistance, with no conversions to open surgery. The success rate of robotic-assisted surgery was 100%. The median patient age was 60 years, and the median body mass index was 25.6 kg/m2. Ten patients had right-sided and 5 had left-sided tumors, with a median tumor diameter of 9.1 cm. According to the Mayo classification, there were 5 cases of grade 0, 4 of grade Ⅰ, 5 of grade Ⅱ, and 1 of grade Ⅲ thrombus. The median operative time was 233.0 min, the median estimated blood loss was 250.0 mL, and 5 patients (33.3%) received blood transfusions. The median postoperative hospital stay was 6 days. Only one patient (6.7%) experienced a Clavien-Dindo grade Ⅱ complication (lymphatic leakage), with no grade ≥Ⅲ severe complications or perioperative mortality. Postoperative pathology revealed clear cell renal cell carcinoma in 12 cases, and venous wall invasion was confirmed in 8 patients (53.3%). After a median follow-up of 4.4 months, one patient developed duodenal metastasis 10 months postoperatively. Conclusion: The domestic Jingfeng MP1000 multi-port robotic system-assisted laparoscopic radical nephrectomy with venous tumor thrombectomy is technically safe and feasible, with favorable perioperative outcomes and a low complication rate. Its long-term oncological efficacy requires further validation through large-scale, prospective studies.

Key words: Kidney neoplasms, Venous tumor thrombus, Robotic-assisted surgery, Radical nephrectomy

CLC Number: 

  • R737.11

Table 1

Clinical characteristics of patients with renal cell carcinoma and venous tumor thrombus"

Feature Jingfeng group (n=15) Da Vinci group (n=227) P value
Age/years 60 (53, 71) 60 (52, 67) 0.482
Male 10 (66.7) 154 (67.8) >0.999
BMI/(kg/m2) 25.6 (24.1, 26.8) 24.2 (22.0, 27.0) 0.085
Side 0.963
    Left 5 (33.3) 78 (34.4)
    Right 10 (66.7) 148 (65.2)
    Bilateral 0 (0) 1 (0.4)
Size/cm 9.1 (7.6, 10.6) 8.7 (6.7, 10.7) 0.613
Mayo classification 0.234
    0 5 (33.3) 46 (20.3)
    Ⅰ 4 (26.7) 27 (11.9)
    Ⅱ 5 (33.3) 122 (53.7)
    Ⅲ 1 (6.7) 19 (8.4)
    Ⅳ 0 (0) 13 (5.7)
ASA 0.834
    Ⅰ 0 (0) 9 (4.0)
    Ⅱ 11 (73.3) 169 (74.4)
    Ⅲ 4 (26.7) 48 (21.1)
    Ⅳ 0 (0) 1 (0.4)
Operative time/min 233.0 (128.0, 274.0) 224.0 (163.5, 303.5) 0.582
Estimated blood loss/mL 250.0 (100.0, 575.0) 400.0 (200.0, 1 000.0) 0.084
Patients receiving transfusion 5 (33.3) 107 (47.1) 0.424
Lymph node dissection 9 (60.0) 140 (61.7) >0.999
Adrenalectomy 11 (73.3) 127 (55.9) 0.282
Postoperative hospital stay/d 6 (5, 8) 7 (5, 9) 0.369
Preoperative Scr/(μmol/L) 100.0 (90.5, 116.0) 93.0 (75.5, 109.0) 0.190
Postoperative Scr/(μmol/L) 103.0 (90.0, 121.0) 104.0 (85.8, 133.0) 0.749
Venous tumor thrombus combined with bland thrombus 1 (6.7) 33 (14.5) 0.702
Histological type 0.890
    Clear cell RCC 12 (80.0) 178 (78.4)
    Papillary RCC 1 (6.7) 11 (4.8)
    TFE3-rearranged RCC 0 (0) 8 (3.5)
    TFEB-altered RCC 0 (0) 2 (0.9)
    Fumarate hydratase-deficient RCC 0 (0) 8 (3.5)
    Unclassified RCC 2 (13.3) 16 (7.0)
    Indeterminate histology due to treatment response 0 (0) 4 (1.8)
Four-tiered WHO/ISUP grading system 0.752
    Ⅰ 0 (0) 1 (0.4)
    Ⅱ 5 (33.3) 43 (18.9)
    Ⅲ 6 (40.0) 104 (45.8)
    Ⅳ 3 (20.0) 59 (26.0)
    Not graded 1 (6.7) 20 (8.8)
T stage 0.762
    T3a 4 (26.7) 45 (19.8)
    T3b 3 (20.0) 61 (26.9)
    T3c 6 (40.0) 103 (45.4)
    T4 2 (13.3) 18 (7.9)
M1 5 (33.3) 73 (32.2) >0.999
Invade the wall of the vena cava 8 (53.3) 140 (61.7) 0.589
Complication 1 (6.7) 57 (25.1) 0.128
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