Laparoscopic renal cryoablation in 32 patients

Gill, Inderbir S.; Novick, Andrew C.; Meraney, Anoop; Chen, Roland N.; Hobart, Michael G.; Sung, Gyung Tak; Hale, John; Schweizer, Dana; Remer, Erick M.

doi:10.1016/s0090-4295(00)00752-4

Cited by 241 publications

(67 citation statements)

References 7 publications

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“…Tumor destroyed with radio frequency ablation or cryotherapy may take months to regress, while the surgical bed after open partial nephrectomy may leave a defect that enhances on CT. 7,15 It is encouraging that all but 1 (18 of 19) of the tumors thought to have been satisfactorily managed at the time of the procedure, with tissue temperatures 70C or greater, lost contrast enhancement 2 months after treatment, with a difference in HU of less than 12.…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

“…[6][7][8] Although high intensity focused ultrasound for renal tumor has yet to be developed clinically, promising early reports of cryotherapy for renal tumors have been published. 7,9 A vast clinical experience has been obtained with radio frequency ablation of liver neoplasms but renal tumor radio frequency ablation is still in infancy. 10,11 Since Zlotta et al introduced radio frequency ablation for human renal tumor in 1997, 12 early results of percutaneous radio frequency ablation as monotherapy for renal tumor have been reported, however, experience is limited.…”

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confidence: 99%

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Percutaneous Radio Frequency Ablation of Small Renal Tumors: Initial Results

et al. 2002

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Purpose-Thermal tissue ablation with radio frequency energy is an experimental treatment of renal tumor. We report early results of an ongoing trial of percutaneous radio frequency ablation for small renal tumors.Materials and Methods-Patients with percutaneously accessible renal tumors were evaluated for radio frequency ablation. Tumors were solid on computerized tomography (CT), 3 cm. or less in diameter and enlarging during at least 1 year. Ablation was performed at the Interventional Radiology suite under ultrasound and/or CT guidance. A 50 W., 460 kHz. electrosurgical generator delivered radio frequency energy via a percutaneously placed 15 gauge coaxial probe. At least 2, 10 to 12-minute ablation cycles were applied to each lesion. Patients were observed overnight before discharge from hospital and reevaluated 2 months later. Conclusions-Percutaneous radio frequency ablation of small renal tumor is well tolerated and minimally invasive. It will remain experimental until procedural and imaging parameters that correlate with tumor destruction are validated. ResultsKeywords kidney neoplasms; carcinoma; renal cell; surgical procedures; minimally invasive Renal tumors are being detected at increasing rates and smaller sizes with modern imaging techniques. Traditional treatment includes partial or radical nephrectomy but non-surgical ablative modalities are an option for patients with contraindications to surgery. The natural history of renal tumor is variable but those less than 3 cm. rarely metasta-size. [1][2][3][4][5] Management options for small renal masses include observation, experimental ablation and surgical removal. NIH Public Access

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Section: Discussionmentioning

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Percutaneous Radio Frequency Ablation of Small Renal Tumors: Initial Results

et al. 2002

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“…The report by Licht and Novick [10] Cryotherapy is the most proven of the available ablative technologies to date, and our work has shown that margin control via thermocouples should provide adequate cell death at the margins [7]. In addition, clinical reports of laparoscopic cryoablation have been good, using the visual ice-ball and ultrasonography for treatment monitoring [1]. Questions remain as to whether when performing renal cryoablation the surgeon should use thermocouples, as we did in this study.…”

Section: Discussionmentioning

confidence: 66%

“…New enthusiasm in cryoablation for small ( < 4 cm) renal tumours has been provoked by the emergence of several promising clinical studies [1][2][3]. However, the available unrandomized clinical studies in cryotherapy still lack extensive follow-up [3].…”

Section: Introductionmentioning

confidence: 99%

Comparison of cryotherapy and nephrectomy in treating implanted VX‐2 carcinoma in rabbit kidneys

Nakada¹,

Jerde²,

Warner³

et al. 2004

BJU International

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OBJECTIVETo compare the efficacy of cryoablation and radical nephrectomy for treating implanted VX‐2 carcinoma in rabbit kidneys.MATERIALS AND METHODSA pilot study was conducted using 27 New Zealand white rabbits to assess the natural history of VX‐2 carcinoma in the kidney. VX‐2 tumour segments (1 mm3) were excised from subcutaneous tumours in carrier rabbits and implanted in the left kidney of study rabbits. The tumours were allowed to grow for 6, 7, 8, 9, 10, 14, 18, 21 and 28 days after implantation. Tumour progression was analysed in the kidney and surrounding serosa, and metastatic tumour presence in the lung, liver, spleen and bladder determined. After this, 80 rabbits were implanted with VX‐2 in the lower pole and randomized into one of three groups: group 1, 35 rabbits treated 7 days after VX‐2 implantation with cryoablation using a 15‐min double‐freeze technique and a 5‐mm tumour margin target temperature of − 20 °C; group 2, 35 rabbits treated with open radical nephrectomy; or group 3, 10 untreated controls. Rabbits were maintained for 22 days and then killed; the kidneys, lungs, liver, spleen, urinary bladder and ureter were removed, and examined grossly and histologically for tumour presence.RESULTSIn the pilot study there was a consistent 50–100 mm3 tumour after 7 days of growth, with no evidence of metastatic disease. By day 10 the mean kidney tumour was 230 mm3 and two of three rabbits had metastases in the lung. By day 18 the mean primary tumour was 5504 mm3 and all rabbits had metastatic disease. In the comparison study, cryotherapy cured 66% of implanted rabbits while nephrectomy cured 64%. All untreated controls had significant local and metastatic tumours. Findings in animals killed at 15 days after treatment showed significant differences between both treatment groups and untreated controls (P < 0.002). There was no difference in disease‐free survival between the cryotherapy and open nephrectomy groups (P = 0.78)CONCLUSIONBoth cryoablation and radical nephrectomy were effective in treating implanted VX‐2 renal tumours compared with untreated controls. There was no statistically significant difference between cryoablation and nephrectomy.

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Imaging after Minimally‐Invasive Interventions in Urological Cancers

Illing

Kirkham

2011

Interventional Techniques in Uro‐Oncology

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Laparoscopic renal cryoablation in 32 patients

Cited by 241 publications

References 7 publications

Percutaneous Radio Frequency Ablation of Small Renal Tumors: Initial Results

Percutaneous Radio Frequency Ablation of Small Renal Tumors: Initial Results

Comparison of cryotherapy and nephrectomy in treating implanted VX‐2 carcinoma in rabbit kidneys

Imaging after Minimally‐Invasive Interventions in Urological Cancers

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