Urologie médicale et chirurgicale
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Abstrait

Laparoscopic Renal Cryoablation: Single Institutional Experience from South America

Andre Costa-Matos, Marcos F Dall'Ogllio, Jose Roberto Colombo Junior, Cesar Camara, Alexandre Crippa Santana, Bruno Tiseo, Fabio Tanno and Srougi M

Objective: Minimal invasive thermal ablative techniques are emerging as a viable option for patients who are not candidates for open, laparoscopic or robotic-assisted partial nephrectomy. Cryoablation is a low risk alternative with good oncologic outcomes. We present our initial experience with cryoablation for small renal masses using the laparoscopic approach.

Patients and Methods: We prospectively collected the perioperative data of patients undergone renal cryoablation at our institution. From May/2009 to January/2011, 41 patients with incidental small renal mass were submitted to laparoscopic cryoablation.

Results: The mean patient age was 58.8 years. The mean operative time was 115.4 ± 60.3 min and no patient needed blood transfusion. The mean of size tumors was 2.8 cm (1-5 cm). Intraoperative biopsies showed 27 (65%) malignant tumors, 5 (12%) oncocytomas, two (6%) angiomyolipomas 7 (17%) inconclusive. With a mean follow-up of 16 months (12-21), there were no significant differences between creatinine, estimated glomerular filtration rate and hemoglobin level before and after the procedure. There was no open conversion, kidney loss, urinary fistula, dialysis requirement or re-operations.

Conclusion: Laparoscopic renal cryoablation is safe, with low complication rate and short learning curve.