Retroperitoneal laparoscopic cryoablation of small renal tumors: intermediate results

Lee, David I.; McGinnis, David E.; Feld, Rick I.; Strup, Stephen E.

doi:10.1016/s0090-4295(02)02004-6

Cited by 110 publications

(34 citation statements)

References 23 publications

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“…The pooled proportion of clinical efficacy was 89% [95% confidential interval (CI) 0.83 to 0.94) in cryoablation therapy from 20 [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] studies with a total of 457 cases. There was statistical significance regarding heterogeneity (I² value)=70.6%) (p<0.0001)…”

Section: Pooled Resultsmentioning

confidence: 99%

An alternative approach to deal with the absence of clinical trials: a proportional meta-analysis of case series studies

2013

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PURPOSE: Systematic reviews are criticized for frequently offering inconsistent evidences and absence of straightforward recommendations. Their value seems to be depreciated when the conclusions are uncertain. To describe an alternative approach of evaluating case series studies in health care when there is absence of clinical trials. METHODS:We provide illustrations from recent experiences. Proportional meta-analysis was performed on surgical outcomes: (a) case series studies, (b) use of cryoablation or radiofrequency ablation, and (c) patients with small renal cell carcinoma. The statistically significant difference between both interventions studied was defined if their combined 95% confidential interval (CI) did not overlap. RESULTS:As demonstrated by the example, this analysis is an alternative approach to provide some evidence of the intervention´s effects under evaluation and plotting all available case series in the absence of clinical trials for the health field. CONCLUSIONS:Although we are leading to a low level of evidence to determine efficacy, effectiveness and safety of interventions this alternative approach can help surgeons, physicians and health professionals for a provisionally decision in health care along with their clinical expertise and the patient´s wishes and circumstances in the absence of high-quality primary studies. It´s not a replacement for the gold standard randomized clinical trial, but an alternative analysis for clinical research. An alternative approach to deal with the absence of clinical trials.A proportional meta-analysis of case series studies

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Section: Pooled Resultsmentioning

confidence: 99%

An alternative approach to deal with the absence of clinical trials: a proportional meta-analysis of case series studies

2013

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“…At a mean radiographic follow-up of 5 months, no tumor recurrence was found. Most recently, Lee et al [12] published their intermediate results with retroperitoneal laparoscopic cryoablation of small renal tumors located peripherally. A total of 20 patients (11 with documented renal cell carcinoma on intraoperative biopsy) with renal masses ranging from 1.4 to 4.5 cm in diameter underwent the procedure.…”

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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“…Cryoablation of renal masses was Wrst described by Uchida et al [2]. Retroperitoneal laparoscopic renal cryoablation was Wrst performed by Gill et al [3] and has subsequently been reported by several other groups [4][5][6][7][8][9]. Given the proximity of the tumor to the ureter and renal hilum, we choose to use robotic assistance to facilitate dissection of these critical structures away from the tumor to minimize collateral damage from the iceball.…”

Section: Discussionmentioning

confidence: 99%