|Renal ablative cryosurgery in selected
patients with peripheral renal masses.
Rodriguez R, Chan DY, Bishoff JT, Chen RB, Kavoussi
LR, Choti MA, Marshall FF.
James Buchanan Brady Urological
Institute, Johns Hopkins Hospital and Johns Hopkins Bayview Hospital,
Baltimore, Maryland 21287-2101, USA.
OBJECTIVES: To present the preliminary results of
renal ablative cryosurgery in selected patients. METHODS: Seven
patients were treated, all of whom had small peripheral tumors and
chose not to undergo partial or radical nephrectomy. Four patients
underwent a rib-sparing flank incision; the remaining three underwent
laparoscopy. All tumors were biopsied before cryoablation. Intraoperative
ultrasound was used to monitor the cryolesion. RESULTS: There were
no intraoperative complications. The estimated blood loss averaged
111 mL. To date, 6 of the 7 patients have undergone at least one
follow-up computed tomography scan (14.2 months average follow-up);
all these scans demonstrated partial resolution of the lesion. Clinically,
the patients tolerated the procedure without any renal complications
or significant changes in creatinine. CONCLUSIONS: This limited
clinical trial has demonstrated the feasibility of treating small
peripherally located renal tumors with cryosurgery with minimal
morbidity and a favorable outcome. Further studies are necessary
to determine the long-term efficacy of this treatment modality.