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Advances in Urology
Volume 2008 (2008), Article ID 197324, 3 pages
http://dx.doi.org/10.1155/2008/197324
Review Article

Cryoablation of Small Renal Tumors in Patients with Solitary Kidneys: Initial Experience

1Department of Urology, Hackensack University Medical Center, 360 Essex Street, Suite 403, Hackensack, NJ 07601, USA
2Department of Urology, Touro University College of Medicine, 360 Essex Street, Suite 403, Hackensack, NJ 07601, USA
3The John Theurer Cancer Center at Hackensack University Medical Center, 20 Prospect Avenue, Hackensack, NJ 07601, USA
4Division of Urology, Department of Surgery, UMDNJ-New Jersey Medical School, 185 South Orange Avenue, Newark, NJ 07103, USA
5Department of Urology, College of Physicians and Surgeons, Columbia University, 161 Fort Washington Avenue, New York, NY 10032, USA

Received 1 May 2008; Accepted 28 August 2008

Academic Editor: J. Rubio

Copyright © 2008 Ravi Munver et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Introduction. The purpose of this study was to evaluate the role of renal cryoablation in patients with solitary kidneys with the goals of tumor destruction and maximal renal parenchymal preservation. Methods. Eleven patients with single tumors were treated with cryoablation, of which 10 patients had solitary kidneys and 1 had a nonfunctioning contralateral kidney. All procedures were performed via an open extraperitoneal approach; ten tumors were treated with in-situ cryoablation and 1 tumor was treated with cryo-assisted partial nephrectomy. Results. Cryoablation was successfully performed without any preoperative complications. Mean patient age was 62.4 years (range 49–79), tumor location included: 6 (upper pole), 2 (mid-kidney), 3 (lower pole). The mean and median tumor size was 2.6 cm and 2.8 cm (range 1.2–4.3 cm), mean operative time 205 minutes (range 180–270 minutes), blood loss 98.5 ml (range 40–250 ml), and hospitalization 4.6 days (range 3–8 days). Creatinine values included: preoperative 1.43 mg/dL (range 1.2–1.9), postoperative 1.67 mg/dL (range 1.5–2.5), and nadir 1.57 mg/dL (range 1.3–2.1). All patients were followed postoperatively with magnetic resonance imaging for surveillance. At a median follow-up of 43 months, 9 patients had no evidence of recurrence, 1 patient has an enhancing indeterminate area, and 1 patient was lost to follow-up. Conclusion. Intermediate-term results suggest that renal cryoablation offers a feasible alternative for patients that require a maximal nephron-sparing effort with preservation of renal function and minimal risk of tumor recurrence.