Haemostatic Radiofrequency Ablation Assisted Partial Nephrectomy: Is Radiofrequency Energy a Viable Solution?

Abstract

Aim: We present our experience with partial nephrectomy using radiofrequency energy in patients with kidney cancer. Methods: From July 2002 to February 2007, 15 radiofrequency ablation assisted partial nephrectomies were performed. Five patients had one kidney only. The average tumour size was 34 (range 22–55) mm, and the mean age was 56 (range 45–69) years. The renal pedicle was not clamped. A monopolar cool-tip radiofrequency device under intra-operative ultrasound guidance was used. Our procedure involved inserting a radiofrequency probe around the tumour. The average ablation time was 6–12 min. Afterwards the tumour was removed and analyzed histopathologically. Results: The average follow-up period was 15 (range 1–42) months. Eleven procedures were performed without any complications. In 4 cases, delayed urine leakage was observed. Histopathological examination revealed 13 clear cell renal cell carcinomas and 2 oncocytomas. In all cases the coagulated surgical margins were negative. Currently, the surviving patients have a well-preserved renal function, and there was no tumour recurrence. Conclusions: Radiofrequency ablation assisted partial nephrectomy seems to be an effective method of nephron-sparing surgery. The major advantages of this procedure include easy tumour extraction and no signs of bleeding.

Laparoscopic Radiofrequency Ablation versus Partial Nephrectomy for cT1a Renal Tumors: Long-Term Outcome of 179 Patients

“…Sommer et al [25] reported their experience of CT-guided percutaneous RFA on 22 patients, although with a high mean age (74.2 ± 8.6 years), and half of those patients showed impaired renal function before RFA; their oncologic and functional results were relatively encouraging. The high technical success rate and limited complications demonstrated that percutaneous RFA is an efficient therapy for either initial or recurrent kidney tumors, especially for those elderly patients with comorbidities [26,27]. But when dealing with tumors in proximity to critical structures such as ureter, bowel and renal vessels, a laparoscopic approach may be preferred for its intrinsic possibility to mobilize these structures and for the higher precision and accuracy during tumor targeting [28].…”

Radiofrequency Ablation: A Minimally Invasive Approach in Kidney Tumor Management

“…In our own series we observed urine leak in three patients who underwent RF-assisted partial nephrectomy. RF energy was used to perform partial nephrectomy without clamping renal pedicle [22]. Fortunately, in most cases urine leak resolves spontaneously, sometimes it requires endoscopic management.…”