67th Annual Meeting Abstracts

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Feasibility and Safety of Ultrasound-Guided Percutaneous Renal Cryoablation: A Novel Approach
*Alyssa M. Park, Brant R. Fulmer, John Danella, Daniel B. Rukstalis
Geisinger Medical Center, Danville, PA

Introduction:
Our Department of Urology has established intensive ultrasound training for both residents and faculty that has resulted in performance of greater than 500 proctored ultrasound examinations during training. These skills have facilitated the development of percutaneous renal cryoablation (PRC) under ultrasound guidance. We previously published our novel technique for ultrasound-guided PRC utilizing the CIVCO assist positioning system. We are now presenting the feasibility and safety in 41 patients undergoing ultrasound-guided PRC using this technique.
Materials & Methods:
An IRB-approved retrospective analysis of a prospective quality improvement database was performed for pertinent clinical outcomes.
Results:
Forty-one of 288 (14%) procedures were performed percutaneously. Selection criteria resulted in a median BMI of 29.4, with 77% of masses being exophytic and 93% being posterior or lateral in location. Median operative time was 48.5 minutes with 2 (1-3) cryoprobes used. Length of stay was 23 hours. Major complications developed in 3 of 41 (7.3%) patients, with 1 patient (2.4%) requiring transfusion. Importantly, one patient treated for a left upper pole lesion suffered a delayed splenic hemorrhage, while another patient treated for a medial lower pole lesion developed an acute ureteral obstruction which resolved with stent placement.
Conclusions:
With appropriate ultrasound training, urologists are capable of performing ultrasound-guided PRC in a safe manner for appropriately selected patients. Ultrasound represents an attractive imaging modality for this procedure due to the absence of radiation exposure and the potential cost reduction.

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