Efficacy of Laparoscopic and Percutaneous Radiofrequency Ablation of Renal Tumor / 대한비뇨기과학회지

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.