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KMID : 0358320080490040287
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Korean Journal of Urology
2008 Volume.49 No. 4 p.287 ~ p.293
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Efficacy of Laparoscopic and Percutaneous Radiofrequency Ablation of Renal Tumor
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Bae Sang-Rak
Kim Tae-Hyo
Sung Gyung-Tak
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Abstract
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Purpose : We report here on the safety and efficacy of nephron-sparing radiofrequency ablation(RFA) for treating renal tumor.
Materials & 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.
Conclusion : 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. (Korean J Urol 2008;49:287-293)
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KEYWORD
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Radiofrequency ablation, Nephron-sparing, Laparoscopy
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