Cryoablation of localized renal cell carcinoma in patients at high surgical risk

Apolihin O.I., Sivkov A.V., Roschin D.A., Pavlov D.A., Koryakin A.V., Ognerubova I.N., Romih F.D.

Aim of the study. To evaluate the safety and efficacy of minimally invasive surgical treatments (cryoablation) of kidney tumors in patients at high surgical risk.

Materials and methods. In the period from March 2010 to October 2013 twelve patients with localized renal cell carcinoma (clinical stage I) underwent cryoablation. The age of patients ranged from 26 to 82 years (median 57 years). Median follow up was 19 months (minimum of 1 month and a maximum of 36 months).

Results. Tumor of the right kidney was observed in 5 (41.7%) patients, left-sided tumorin 7 (58.3%) patients. Thus, in 3 (25%) tumors were located on the front surface of the kidney, in 4 (33.3%) cases – at the anterior-lateral region, in 2 (16.7%) cases – at the rear surface and in another 3 (25%) – on the back-lateral surface of the kidney. Lower pole and the middle segment tumor localizations were registered with the same frequency (each was found in 4 (33.3%) of the patients). In 3 (25%) patients and in 1 (8.4%) patient – tumor was detected on the border of the upper pole and the middle segment of kidney and on the border of the middle segment and the lower pole respectively. According to the scale of the American Association of Anaesthetists – ASA, in 8 (66.6%) of the patients physical condition was assessed as Class II, in 3 patients (25%) – as class III and only 1 (8.4%) – as I class. The mean operative time was 145 ± 15.2 min, mean blood loss – 262 ± 158.6 ml. Early and/or late postoperative complications were not registered in any case. Histopathology in all cases showed clear cell renal cell carcinoma. Drainage period ranged from 1 to 3 days. Average hospital stay – 10 ± 1.1 days.

Conclusions. The data from our center demonstrates good results of cryoablation and lack of postoperative complications in patients at high risk of developing chronic renal failure.

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