Efficacy of laparoscopic renal cryoablation as an alternative treatment for small renal mass in patients with poor operability

Experience from the korean single center

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Abstract

Objective: The aim of this work was to evaluate the efficacy and safety of laparoscopic renal cryoablation (LRC) for the treatment of incidentally found small renal masses in patients with poor operability, from our initial experience in Korea. Materials and Methods: From June 2005 to April 2009, surgical and oncologic outcomes were evaluated from a database of 45 renal tumors in 39 patients who underwent LRC due to a high American Society of Anesthesiology (ASA) physical status score (i.e., over 3) or old age (i.e., over 70 years old). Results: Mean (range) age was 63.3 years (range, 43-81), and mean tumor size was 2.5cm (range 0.7-3.9). Mean of ASA physical status score of whole patients was 2.8 (range, 1-4), and 79.4% (31/39) of patients had an ASA physical status score over 3. Eleven patients (28.2%) were over 70 years old. Among 45 treated lesions, 23 (51.1%) were exophytic tumors, 17 (37.8%) were endophytic tumors, and the other 5 (11.1%) were mesophytic tumors. Mean operating time was 173.7 minutes (range, 110-220), and mean blood loss was 106.3mL (range, 40-150). None of the patients developed major complications, including adjacent organ injury, collecting system injury, open surgical conversion, or conversion to nephrectomy. Pathologic examination revealed that 60% (27/45) of lesions were renal-cell carcinoma (RCC). During a mean follow-up duration of 23.5 months (range, 6-53), radiologic evidence of tumor recurrence was found in 1 patient (3.7% for RCC). With the exception of this patient, all other patients have remained free of recurrence or metastasis, as determined by a periodic radiologic work-up. Serum creatinine remains stable, with no statistical difference, compared to preoperative levels, in both whole patients and patients with solitary kidney. Conclusions: In this series, LRC for small renal tumors showed favorable oncologic and surgical outcomes, including maintenance of renal function, without adverse effects in selected patients with poor operability.

Original languageEnglish
Pages (from-to)339-345
Number of pages7
JournalJournal of Laparoendoscopic and Advanced Surgical Techniques
Volume20
Issue number4
DOIs
Publication statusPublished - 2010 May 1

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Cryosurgery
Kidney
Anesthesiology
Therapeutics
Neoplasms
Renal Cell Carcinoma
Recurrence
Intraoperative Complications
Korea
Nephrectomy
Creatinine

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

Cite this

@article{82d90ce0eaf948389f88cb007836d386,
title = "Efficacy of laparoscopic renal cryoablation as an alternative treatment for small renal mass in patients with poor operability: Experience from the korean single center",
abstract = "Objective: The aim of this work was to evaluate the efficacy and safety of laparoscopic renal cryoablation (LRC) for the treatment of incidentally found small renal masses in patients with poor operability, from our initial experience in Korea. Materials and Methods: From June 2005 to April 2009, surgical and oncologic outcomes were evaluated from a database of 45 renal tumors in 39 patients who underwent LRC due to a high American Society of Anesthesiology (ASA) physical status score (i.e., over 3) or old age (i.e., over 70 years old). Results: Mean (range) age was 63.3 years (range, 43-81), and mean tumor size was 2.5cm (range 0.7-3.9). Mean of ASA physical status score of whole patients was 2.8 (range, 1-4), and 79.4{\%} (31/39) of patients had an ASA physical status score over 3. Eleven patients (28.2{\%}) were over 70 years old. Among 45 treated lesions, 23 (51.1{\%}) were exophytic tumors, 17 (37.8{\%}) were endophytic tumors, and the other 5 (11.1{\%}) were mesophytic tumors. Mean operating time was 173.7 minutes (range, 110-220), and mean blood loss was 106.3mL (range, 40-150). None of the patients developed major complications, including adjacent organ injury, collecting system injury, open surgical conversion, or conversion to nephrectomy. Pathologic examination revealed that 60{\%} (27/45) of lesions were renal-cell carcinoma (RCC). During a mean follow-up duration of 23.5 months (range, 6-53), radiologic evidence of tumor recurrence was found in 1 patient (3.7{\%} for RCC). With the exception of this patient, all other patients have remained free of recurrence or metastasis, as determined by a periodic radiologic work-up. Serum creatinine remains stable, with no statistical difference, compared to preoperative levels, in both whole patients and patients with solitary kidney. Conclusions: In this series, LRC for small renal tumors showed favorable oncologic and surgical outcomes, including maintenance of renal function, without adverse effects in selected patients with poor operability.",
author = "Ko, {Young Hwii} and Hoon Choi and Sung-Gu Kang and Park, {Hong Seok} and Lee, {Jeong Gu} and Je-Jong Kim and Kang, {Seok Ho} and Jun Cheon",
year = "2010",
month = "5",
day = "1",
doi = "10.1089/lap.2009.0431",
language = "English",
volume = "20",
pages = "339--345",
journal = "Journal of Laparoendoscopic and Advanced Surgical Techniques - Part A",
issn = "1092-6429",
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}

TY - JOUR

T1 - Efficacy of laparoscopic renal cryoablation as an alternative treatment for small renal mass in patients with poor operability

T2 - Experience from the korean single center

AU - Ko, Young Hwii

AU - Choi, Hoon

AU - Kang, Sung-Gu

AU - Park, Hong Seok

AU - Lee, Jeong Gu

AU - Kim, Je-Jong

AU - Kang, Seok Ho

AU - Cheon, Jun

PY - 2010/5/1

Y1 - 2010/5/1

N2 - Objective: The aim of this work was to evaluate the efficacy and safety of laparoscopic renal cryoablation (LRC) for the treatment of incidentally found small renal masses in patients with poor operability, from our initial experience in Korea. Materials and Methods: From June 2005 to April 2009, surgical and oncologic outcomes were evaluated from a database of 45 renal tumors in 39 patients who underwent LRC due to a high American Society of Anesthesiology (ASA) physical status score (i.e., over 3) or old age (i.e., over 70 years old). Results: Mean (range) age was 63.3 years (range, 43-81), and mean tumor size was 2.5cm (range 0.7-3.9). Mean of ASA physical status score of whole patients was 2.8 (range, 1-4), and 79.4% (31/39) of patients had an ASA physical status score over 3. Eleven patients (28.2%) were over 70 years old. Among 45 treated lesions, 23 (51.1%) were exophytic tumors, 17 (37.8%) were endophytic tumors, and the other 5 (11.1%) were mesophytic tumors. Mean operating time was 173.7 minutes (range, 110-220), and mean blood loss was 106.3mL (range, 40-150). None of the patients developed major complications, including adjacent organ injury, collecting system injury, open surgical conversion, or conversion to nephrectomy. Pathologic examination revealed that 60% (27/45) of lesions were renal-cell carcinoma (RCC). During a mean follow-up duration of 23.5 months (range, 6-53), radiologic evidence of tumor recurrence was found in 1 patient (3.7% for RCC). With the exception of this patient, all other patients have remained free of recurrence or metastasis, as determined by a periodic radiologic work-up. Serum creatinine remains stable, with no statistical difference, compared to preoperative levels, in both whole patients and patients with solitary kidney. Conclusions: In this series, LRC for small renal tumors showed favorable oncologic and surgical outcomes, including maintenance of renal function, without adverse effects in selected patients with poor operability.

AB - Objective: The aim of this work was to evaluate the efficacy and safety of laparoscopic renal cryoablation (LRC) for the treatment of incidentally found small renal masses in patients with poor operability, from our initial experience in Korea. Materials and Methods: From June 2005 to April 2009, surgical and oncologic outcomes were evaluated from a database of 45 renal tumors in 39 patients who underwent LRC due to a high American Society of Anesthesiology (ASA) physical status score (i.e., over 3) or old age (i.e., over 70 years old). Results: Mean (range) age was 63.3 years (range, 43-81), and mean tumor size was 2.5cm (range 0.7-3.9). Mean of ASA physical status score of whole patients was 2.8 (range, 1-4), and 79.4% (31/39) of patients had an ASA physical status score over 3. Eleven patients (28.2%) were over 70 years old. Among 45 treated lesions, 23 (51.1%) were exophytic tumors, 17 (37.8%) were endophytic tumors, and the other 5 (11.1%) were mesophytic tumors. Mean operating time was 173.7 minutes (range, 110-220), and mean blood loss was 106.3mL (range, 40-150). None of the patients developed major complications, including adjacent organ injury, collecting system injury, open surgical conversion, or conversion to nephrectomy. Pathologic examination revealed that 60% (27/45) of lesions were renal-cell carcinoma (RCC). During a mean follow-up duration of 23.5 months (range, 6-53), radiologic evidence of tumor recurrence was found in 1 patient (3.7% for RCC). With the exception of this patient, all other patients have remained free of recurrence or metastasis, as determined by a periodic radiologic work-up. Serum creatinine remains stable, with no statistical difference, compared to preoperative levels, in both whole patients and patients with solitary kidney. Conclusions: In this series, LRC for small renal tumors showed favorable oncologic and surgical outcomes, including maintenance of renal function, without adverse effects in selected patients with poor operability.

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U2 - 10.1089/lap.2009.0431

DO - 10.1089/lap.2009.0431

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JF - Journal of Laparoendoscopic and Advanced Surgical Techniques - Part A

SN - 1092-6429

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ER -