2008 Annual Meeting Abstracts

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“Ultrasound-guided Renal Cryoablation: Outcomes For Open, Laparoscopic, And Percutaneous Approaches”
Alyssa Park*, Brant Fulmer, John Danella, Daniel B. Rukstalis
Geisinger Medical Center, Danville, PA

“Ultrasound-Guided Renal Cryoablation: Outcomes for Open, Laparoscopic, and Percutaneous Approaches”
Introduction
Ultrasound imaging supports the minimally invasive approach to renal cryoablation with few comparative studies available for determining the optimal approach.
Methods
We examined data from a consecutive series of 231 patients treated between 1996 and 2007. Thirty-three, 158, and 40 patients underwent open (ORC), laparoscopic (LRC), and percutaneous renal cryoablation (PRC), respectively.
Results
With a median follow-up of 62 months there were no treatment failures in the ORC group. Average length of stay (LOS) was 3.18 days. Only 1 (3%) required transfusion.
A total of 158 LRC’s in 148 patients, with a median follow-up of 13.3 months and 1.55 days LOS demonstrated a 6.8% retreatment rate. Six patients (3.8%) developed perioperative bleeding; 3 (1%) required transfusion. Other postoperative events were pneumothorax and colonic injury each in 1 patient (0.6%).
Median follow-up for PRC was 19.65 months. Average LOS was 23 hours. One patient (2.5%) developed a delayed splenic hemorrhage requiring intervention. One patient (2.5%) with a solitary kidney developed anuria requiring stenting. 3/40 (7.5%) required a repeat procedure.
Cancer-specific survival rates were 100% in the ORC group, 98% in the LRC group, and 97.5% in the PRC group. Overall survival rates were 90.9%, 94.5%, and 95%, respectively.
Conclusions
Ultrasound guided renal cryoablation may be performed with an open, laparoscopic or percutaneous approach with a low risk of transfusion or renal injury. The more minimally invasive procedures are associated with a risk of disease persistence.

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