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Organo Oficial de la Sociedad Mexicana de Urología

2011, Number 2

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Rev Mex Urol 2011; 71 (2)

Cryoablation use in small renal masses

Xochipiltecatl-Muñoz DJ, Lopez-Conde LR, Castellanos-Hernández H, Neave-Sánchez E, García-Villa PC, De la Cruz-Gutierrez SM, Figueroa-Zarza M, Velázquez-Macías RF

Language: Spanish
References: 18
Page: 93-97
PDF size: 135.35 Kb.


ABSTRACT

Minimally invasive ablative techniques have recently emerged as a potential treatment option for clinically localized renal cell carcinoma. Effective renal cryoablation has been achieved through open and laparoscopic approach as well as through imaging technique-guided percutaneous approach.
Methods: A case series study with no controls was carried out on four patients that underwent cryoablation for small renal masses measuring less than three centimeters. Masses were reinforced with contrast medium during tomographic study and computed axial tomography-guided percutaneous biopsy was carried out at the Hospital Central Sur de Alta Especialidad of PEMEX Picacho.
Results: Four cases were included (two women and two men). Age interval in patients was from 32-78 years with a mean age of 63 years ± 21SD. Renal mass volume measured by computed axial tomography had an interval of 14.0-30.0 mm with a mean of 24 mm ± 6.9 SD. There were no complications. During six-month follow-up, one patient presented with new image suggestive of tumor. Percutaneous biopsy was carried out reporting only postcryoablation fibrosis and necrosis. The remaining patients have been monitored by means of tomographic studies and no images suggestive of tumors have been found.
Discussion: Percutaneous renal cryoablation continues to demonstrate its validity as an effective treatment method for renal masses in selected patients. Early results of percutaneous cryoablation have shown favorable results. Various studies have shown local control rates of 83-95% based on short-term follow-up (mean 8-19 months). Cryoablation is a relatively safe procedure with a low serious complication rate when compared with other modalities. The complication rate can be further reduced through careful selection of the patient, technique and approach.
Conclusions: Cryotherapy in renal masses is a promising, minimally invasive procedure with a low complication rate. It is a treatment option for adequately selected patients in whom it is important to spare the rest of the renal parenchyma. However, this procedure is still limited in Mexico due to high cost and lack of experience in the technique.


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