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    Korean J Urol. 2008 Apr;49(4):287-293. Korean.
    Published online Apr 30, 2008.
    https://doi.org/10.4111/kju.2008.49.4.287
    Copyright © 2008 The Korean Urological Association
    Original Article

    Efficacy of Laparoscopic and Percutaneous Radiofrequency Ablation of Renal Tumor

    Sang Rak Bae, Tae Hyo Kim and Gyung Tak Sung
    Received October 02, 2007; Accepted March 12, 2008.

    Abstract

    Purpose

    We report here on the safety and efficacy of nephron-sparing radiofrequency ablation (RFA) for treating renal tumor.

    Materials and Methods

    Starting June 2004, a total of 14 patients underwent RFA for renal tumor during the following 3 years. Of these, 12 cases were followed up for at least 6 months postoperatively. Eight cases of combined computed tomography (CT) and ultrasonogram-guided percutaneous RFA, and four cases of intraoperative ultrasonography-guided laparoscopic RFA were performed with mean follow-up of 18.2 months (range: 4-27 months). The treatment indications were a localized, small (<4cm), solid renal mass in the elderly patients and those patients with co-morbid conditions. Physical examination, CBC, determining the serum creatinine levels and urine analysis were performed for the follow-up laboratory study and kidney CT was performed at day 1, 1 week, 1 month, 3 months, 6 months and 1 year after ablation and thereafter semi-annually. The mean follow-up duration was 18.2 months (range: 4-27 months).

    Results

    All the patients underwent successful RFA without any serious events. Four patients had mild perinephric hematoma on the follow-up CT scan and there was one case of mild gross hematuria postoperatively. With a mean follow-up of 18.2 months, two patients showed residual tumor at 3 months & 22 months, respectively, on the follow-up contrast-enhanced CT after the first tumor ablation. One patient underwent a second RFA and another patient underwent laparoscopic radical nephrectomy, and no residual tumor was seen on the follow-up CT. Distant metastasis was not found in any cases and all the patients are alive on serial follow-up.

    Conclusions

    Percutaneous or laparoscopic RFA is considered a useful treatment for selected patients who have a small renal mass, and to spare the nephrons. The ultimate role of this modality will continue to evolve and this warrants further studies.

    Keywords
    Radiofrequency ablation; Nephron-sparing; Laparoscopy

    Figures

    Fig. 1
    (A) The follow up CT scan image 24 hours after radiofrequency ablation (RFA) shows slightly enhanced peripheral lesion. (B) The follow up CT image 1 month after RFA shows no contrast enhancement of the left renal tumor, but a slightly increased size. (C) The follow up CT image 6 month after RFA shows a decreased tumor size compared to that immediately after RFA. (D) The follow up CT image 9 month after RFA shows a more decreased tumor size.

    Tables

    Table 1
    The patient characteristics and pre-operative status of the 12 cases

    Table 2
    Results of radiofrequency ablation in the 12 patients

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    MeSH Terms
    Aged
    Creatinine
    Follow-Up Studies
    Hematoma
    Hematuria
    Humans
    Kidney
    Laparoscopy
    Neoplasm Metastasis
    Neoplasm, Residual
    Nephrectomy
    Nephrons
    Physical Examination
    Metrics
    Share
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