Percutaneous Radiofrequency Ablation of a Small Renal Mass Complicated by Appendiceal Perforation

Boone, Judith; Bex, Axel; Prevoo, Warner

doi:10.1007/s00270-011-0281-0

Cited by 7 publications

(5 citation statements)

References 21 publications

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“…Similar complications have been noted previously. 21 A possible reason for this complication was that although hydrodissection was performed prior to MWA, the patient had previous abdominal viscera adhesions such that the bowel was not at a sufficient distance from the ablative field to avoid damage. The vital structures remained near the ablative field, which resulted in severe intestinal injury.…”

Section: Discussionmentioning

confidence: 99%

Complications of ultrasound-guided percutaneous microwave ablation of renal cell carcinoma

Dong¹,

Li²,

Yu³

et al. 2016

OTT

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PurposeTo retrospectively review the complications of ultrasound (US)-guided percutaneous microwave ablation (MWA) of renal cell carcinoma.Patients and methodsIn this study, 101 patients with 105 tumors seen from April 2006 to Feb 2014 were enrolled retrospectively. The patients were treated with US-guided percutaneous MWA and were followed up with contrast-enhanced US and computed tomography or magnetic resonance imaging at 1, 3, and 6 months and every 6 months thereafter.ResultsTechnical success was achieved in 99 of 105 tumors (94.3%). The median follow-up time was 25 (range 1.13–93.23) months. Among the 105 tumors, 26 complications in 24.8% of patients and 23 minor complications (Clavien–Dindo Grades I and II) in 21.9% of patients were noted, accounting for 88.5% of all complications. All the minor complications were cured. Three major complications (Clavien–Dindo Grade ≥III) occurred in 2.9% of the patients, accounting for 11.5% of all complications: hydrothorax in two patients and bowel injury in one. The two patients who had hydrothorax post-MWA had a history of cirrhosis and were treated with catheter drainage. The bowel injury was treated surgically. In all patients, the changes in serum creatinine and urea nitrogen levels from before to after the procedure were small.ConclusionUS-guided percutaneous MWA is a beneficial treatment for renal cell carcinoma in selected patients; however, if the renal tumor is close to the bowel, or the patient has serious comorbidities or has undergone abdominal surgery, the procedure must be performed more carefully.

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Section: Discussionmentioning

confidence: 99%

Complications of ultrasound-guided percutaneous microwave ablation of renal cell carcinoma

Dong¹,

Li²,

Yu³

et al. 2016

OTT

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“… 14 In the literature, there are 7 published case reports of bowel injuries secondary to renal ablative techniques. 9 , 15 - 19 Of these, 5 cases occurred after cryoablation, 16 - 19 1 case occurred after radiofrequency ablation, 15 and one occurred after MWA. 9 Among these case reports, injuries affected the colon and the small intestine, leading to sepsis, formation of abscesses or fistulae, and bleeding.…”

Section: Discussionmentioning

confidence: 99%

“… 9 Among these case reports, injuries affected the colon and the small intestine, leading to sepsis, formation of abscesses or fistulae, and bleeding. 9 , 15 - 19 With medical management alone, more than half of the cases had complete resolution of the fistulae or infection. Among the published cases, a surgical approach was preferred when there was uncontrolled hemorrhage, overwhelming infection, or debilitating symptoms affecting the patient’s quality of life.…”

Section: Discussionmentioning

confidence: 99%

“…Among the published cases, a surgical approach was preferred when there was uncontrolled hemorrhage, overwhelming infection, or debilitating symptoms affecting the patient’s quality of life. 9 , 15 , 19 Our patient was a poor surgical candidate and therefore was treated conservatively with procedures guided by interventional radiology to drain the abscess and control active bleeding. However, it is difficult to interpret the efficacy of the chosen approach in this patient because his multiple medical problems led to cardiac arrest during the hospitalization.…”

Section: Discussionmentioning

confidence: 99%

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Duodenorenal Fistula after Microwave Ablation Presenting as Melena

Mukthinuthalapati

Attar

Mutneja

et al. 2018

ACG Case Reports Journal

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A 53-year-old man presented with melena 3 months after microwave ablation of a renal mass. Esophago-gastroduodenoscopy and radiological imaging revealed that a fistulous tract extended from the duodenum to the right kidney. The patient had a hemorrhage that originated from a branch of the renal artery and bled through the fistulous tract into the duodenal lumen. Angiography was used in the successful coiling of the bleeding vessel to control the bleeding. Consideration of a fistulous tract as a source of gastrointestinal bleeding should be included in a clinician’s differential diagnosis when dealing with patients who had a recent ablative procedure.

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“…Where bowel is located immediately adjacent to the tumor, a safety distance to the ablation probe can be created by means of hydrodissection. This is achieved by advancing a 20G tap cannula between the tumor and the bowel and then injecting 100-500 mL of 5% dextrose solution or air ( Figure 1) to create a protective thermal insulation zone (19,20).…”

Section: Technique Preparation and Intervention Guidementioning

confidence: 99%

Thermal Ablation of Renal Tumors

Regier

Chun²

2015

Deutsches Ärzteblatt International

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The thermoablative techniques are an important addition to the armamentarium of effective treatments for locally confined renal tumors. The guidelines of the American and European urological societies now list thermoablation with RFA or CA as an option for the treatment of small renal tumors with curative intent. Thermoablation of renal tumors has not yet been studied in randomized controlled trials; these will be needed so that the efficacy of tumor control, survival rates, complication rates, and quality of life after treatment can be reliably evaluated to provide definitive confirmation of the value of interstitial techniques.

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Percutaneous Radiofrequency Ablation of a Small Renal Mass Complicated by Appendiceal Perforation

Cited by 7 publications

References 21 publications

Complications of ultrasound-guided percutaneous microwave ablation of renal cell carcinoma

Complications of ultrasound-guided percutaneous microwave ablation of renal cell carcinoma

Duodenorenal Fistula after Microwave Ablation Presenting as Melena

Thermal Ablation of Renal Tumors

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