Laparoscopic Application Of Radio Frequency Energy Enables In Situ Renal Tumor Ablation And Partial Nephrectomy

Jacomides, Lucas; Ogan, Kenneth; Watumull, Lori M; Cadeddu, Jeffrey A.

doi:10.1097/00005392-200301000-00012

Cited by 22 publications

(34 citation statements)

References 17 publications

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“…Our study is not designed to compare RFA results with those of conservative surgery; however, in terms of safety, short-term local efficacy and mid-term patient outcome, RFA results seem to be better compared to those from surgical series [6]. Its clinical use in association with laparoscopic surgery has already been reported [12,13], and the substitution of laparoscopic partial nephrectomy by minimally invasive techniques has been suggested [14]. Our RFA series cannot be correctly compared with other non-surgical treatments (cryotherapy above all), but according to data from the literature, it does not seem to be less useful [1].…”

Section: Discussionmentioning

confidence: 94%

Percutaneous US-guided RF thermal ablation for malignant renal tumors: preliminary results in 13 patients

et al. 2004

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Minimally invasive treatment for small renal cell carcinoma (RCC) can be necessary in selected patients and, anyway, is desirable. In situ ablation techniques, including RFA, have been developed. The aim of this study is to evaluate the feasibility, safety and short-term local effectiveness of percutaneous US-guided RFA in a small series, as well as mid-term patient outcome. Thirteen patients with a total of 18 tumors (17 small lesions, 35 mm in size or less, and a larger one, 75 mm in size) underwent 19 RFA sessions. Seven patients had a solitary kidney, and three suffered from VHL disease, too. We treated four lesions in a patient with a bilateral tumor. In another patient, three lesions were ablated. Seventeen tumors were RCC; one was a metastasis from lung cancer. Eight lesions were parenchymal, six exophytic, two parenchymal/exophytic, one parenchymal/central and one central. A monopolar RF system with multitined expandable electrode needles was used. The 35-mm lesion underwent two sessions; the 75-mm lesion was treated with transcatheter arterial embolization before RFA. Tumors with complete loss of contrast enhancement at short-term CT (or MR) were considered successfully treated. Percutaneous US-guided RFA was always feasible without major complications. The success rate after a single treatment in tumors less than 35 mm in size was 88.2% (15/17) and rose to 94.1% (16/17) after the second treatment of the largest lesion. After a mean 14-month follow-up, no successfully treated lesions recurred locally. Only the patient with metastasis from lung cancer died from disease progression in a further location, while all other patients are alive, with renal function still sufficient to avoid dialysis. US guidance allows an easy and safe percutaneous approach for RFA of small non-parahilar RCC. The treatment is locally effective and can be proposed as a minimally invasive therapy for patients with contraindications to surgery or to those expressing an informed consent. Based on the results of this study and of the literature, mid-term results on the clinical usefulness are very encouraging.

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Section: Discussionmentioning

confidence: 94%

Percutaneous US-guided RF thermal ablation for malignant renal tumors: preliminary results in 13 patients

et al. 2004

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“…Jacomides et al [26] used a Model 1500X system (RITA Medical Systems, Inc., Mountain View, CA) to treat 17 renal tumors (mean, 1.96 cm) laparoscopically. Five ablated lesions were immediately excised for pathologic analysis.…”

Section: Clinical Resultsmentioning

confidence: 99%

Update on minimally invasive approaches to kidney tumors

Hwang

Walther²

2004

Curr Urol Rep

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Renal tumors are being detected at increasing rates because of widespread use of modern imaging techniques such as ultrasonography and computed tomography. Typically, these tumors, many of which are discovered incidentally, tend to be small and are confined to the kidney. Advances in ablative and imaging technology have led to the application of minimally invasive therapy in the treatment of small renal tumors. Although still evolving as a cancer treatment, minimally invasive treatment potentially offers several advantages over conventional open renal surgery: shorter convalescence, improved cosmesis, reduced postoperative pain, and renal preservation. This article reviews the status and recent progress of minimally invasive approaches to renal neoplasm.

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“…Most of the ablative technologies can be used laparoscopically or percutaneously; however, many authors believe that tumors on the anterior or medial aspect of the kidney should be approached laparoscopically [6,7]. The two most studied and commonly used modalities for renal ablation are RFA and cryoablation.…”

Section: Discussionmentioning

confidence: 99%

“…These side effects are reported to be higher than RFA in a porcine liver model [11], but have not been reproduced in a kidney model. Animal studies comparing RFA with cryoablation have showed that cryoablation causes less injury to the renal collecting systems [12], whereas RFA is less likely to produce significant hemorrhage [6,9,12]. Although the use of cryotherapy and RFA is safe and proving to be efficacious in the short term, the search for improved minimally invasive ablative therapies continues.…”

Section: Discussionmentioning

confidence: 99%

Guidelines for Power and Time Variables for Microwave Ablation in an In Vivo Porcine Kidney

Hope

Schmelzer

Newcomb

et al. 2009

Journal of Surgical Research

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Laparoscopic Application Of Radio Frequency Energy Enables In Situ Renal Tumor Ablation And Partial Nephrectomy

Cited by 22 publications

References 17 publications

Percutaneous US-guided RF thermal ablation for malignant renal tumors: preliminary results in 13 patients

Percutaneous US-guided RF thermal ablation for malignant renal tumors: preliminary results in 13 patients

Update on minimally invasive approaches to kidney tumors

Guidelines for Power and Time Variables for Microwave Ablation in an In Vivo Porcine Kidney

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