Laparoscopic Completion Nephrectomy for Local Surgical Bed Recurrence After Partial Nephrectomy: An Analysis of Procedural Complexity and Feasibility

Cryoablation for recurrent renal tumors after primary nephron-sparing surgery using an innovative liquid nitrogen-based cryogenic device

“…Shah et al, recently summarized their experience with 45 patients displaying tumor recurrence after NSS. Of those managed by laparoscopy, 48.5% had complications and 36% were converted to open nephrectomy [8]. A similar rate of complications was also reported by Boris et al, [16].…”

“…Such surgical intervention may result in tumor bed recurrence. The currently accepted approach for local failure after NSS is radical nephrectomy [8,9]. This challenging procedure is associated with high complication rate and loss of renal function16.…”

“…Follow up of 37 months post procedure with gradual disappearance of the tumor. These results are more favorable compared to partial or radical nephrectomy using either open or minimally invasive approaches [8]. Completion nephrectomy for true locoregional recurrence might be a technically demanding procedure associated with significant postoperative morbidity and a high rate of open conversion.…”

“…The increased use of this surgical procedures resulted in higher rates of local failure [6,7]. Currently the accepted treatment for local recurrence after NSS is radical nephrectomy by either open or minimally invasive approach [8,9]. Such salvage procedures are associated with a very high complication rate as well as loss of functional renal parenchyma [5,10].…”

Percutaneous Ablation Versus Surgical Resection for Local Recurrence Following Partial Nephrectomy for Renal Cell Cancer: A Propensity Score Analysis (REPART Study—UroCCR 71)

“…Only a few studies specifically focused their attention on oncological and functional outcomes, and the data on this issue are limited [3]. Consequently, questions remain regarding the optimal therapeutic approach for these lesions: (1) completion nephrectomy is an excellent option to achieve oncological control but puts patients at risk of chronic kidney disease (CKD) [4], (2) repeat nephron-sparing surgery is technically challenging and associated with significant morbidity [5], and (3) percutaneous ablation (PCA) such as radiofrequency ablation (RFA) or cryotherapy are increasingly utilized and seems to be an interesting alternative option with promising initial results [6].…”