Results of laparoscopic cryoablation in the treatment of small renal masses

CONTEXT: Study of clinical outcome in renal cryoablation. AIMS: Laparoscopic cryoablation (LCA) is emerging as a reliable treatment option for small renal masses (SRMs) particularly in elderly patients. Our aim was to study the results of cryoablation for small renal masses in our cohort of patients. SETTINGS AND DESIGN: We retrospectively studied all patients who underwent LCA for SRMs between September 2005 and July 2008. MATERIALS AND METHODS: All patients were discussed in our multidisciplinary meeting prior to cryoablation. Our LCA protocol included two freeze-thaw cycles, achieving a core temperature of –70°C and a peripheral temperature of at least –40°C. Follow-up included serum creatinine measurements and pre- and postcontrast CT scans at 3, 6, 12, 18, and 24 months and yearly thereafter. STATISTICAL ANALYSIS USED: Paired samples t-test was used to study statistical difference. RESULTS: Twenty-two patients underwent LCA with a mean (range) age of 68 (39–81 years) years. The mean (range) tumor size was 29 (19–45 mm) mm. Two patients required blood transfusions, one patient developed pneumonia, and another patient developed a small area of skin necrosis at the cryoneedle entry site. The average (range) hospital stay was 4 (2–14 days) days. Twenty-one patients have had CT follow-up at a mean (range) of 24 (4–42 months) months. Three of the 21 tumors showed central enhancement on follow-up CT scans, consistent with treatment failure. CONCLUSIONS: Laparoscopic cryoablation is a safe treatment option for SRM in a selected group of patients.