Purpose: The published laparoscopic renal cryoablation (LRC) series with a minimum of 3 years follow-up demonstrate radiographic success rates over 96%, in treatment for small renal mass (<4cm). While LRC shows advantages in morbidities, hospital stay and renal function, tumor recurrence and complic...
Purpose: The published laparoscopic renal cryoablation (LRC) series with a minimum of 3 years follow-up demonstrate radiographic success rates over 96%, in treatment for small renal mass (<4cm). While LRC shows advantages in morbidities, hospital stay and renal function, tumor recurrence and complications have been reported when expending indication for LRC. Therefore this study is evaluated the oncologic and surgical effectiveness of LRC using 3rd generation cryoablation technique according to tumor size.
Patients and Methods : From August 2004 to October 2008, 37 patients who underwent LRC for 40 renal tumors are enrolled. For these patients, oncologic and perioperative outcomes including tumor recurrence, complications, estimated blood loss, operation time and hospital days were surveyed retrospectively. According to the tumor size (diameter of tumor: D), the patients were stratified into four groups. In group 1, the patients presented with a maximum tumor diameter of 1 cm or from 1 cm to 2cm (1≤D<2cm). In group 2, 2cm or from 2cm to 3cm (2≤D<3cm). In group 3, 3cm or from 3cm to 4cm (3≤D<4cm). And in group 4, 4cm or lager (4cm≤D).
Results :. The mean age and tumor size were 68.0 ± 6.96 years and 1.5 ± 0.24 cm in group 1, 62.42 ± 11.77 years and 2.14 ± 0.16cm in group 2, 67.36 ± 12.39 years and 3.28 ± 0.29cm in group 3, 59.0 ± 15.29 years and 5.07 ± 1.66cm in group 4. The four groups were similar in age, sex, BMI, ASA, baseline renal function, hemoglobin, hospital stay showing no statistic difference, but operation time, estimated blood loss and complication were statistically different (p=0.045, 0.018 and 0.041). During the mean follow-up of 24.5 months, there were 6 complications in group 3 and 4 that were 5 postoperative transfusions and 1 conversion to open renal cryoablation. And there were 2 recurrences of tumor in group 4 (p=0.003).
Conclusions: LRC of renal tumors smaller than 3cm is effective without oncological recurrence and complication. LRC for renal tumors lager than 3cm in diameter is associated with higher transfusion rates. LRC for renal tumor lager than 4cm in diameter is associated with higher recurrence rates.
Purpose: The published laparoscopic renal cryoablation (LRC) series with a minimum of 3 years follow-up demonstrate radiographic success rates over 96%, in treatment for small renal mass (<4cm). While LRC shows advantages in morbidities, hospital stay and renal function, tumor recurrence and complications have been reported when expending indication for LRC. Therefore this study is evaluated the oncologic and surgical effectiveness of LRC using 3rd generation cryoablation technique according to tumor size.
Patients and Methods : From August 2004 to October 2008, 37 patients who underwent LRC for 40 renal tumors are enrolled. For these patients, oncologic and perioperative outcomes including tumor recurrence, complications, estimated blood loss, operation time and hospital days were surveyed retrospectively. According to the tumor size (diameter of tumor: D), the patients were stratified into four groups. In group 1, the patients presented with a maximum tumor diameter of 1 cm or from 1 cm to 2cm (1≤D<2cm). In group 2, 2cm or from 2cm to 3cm (2≤D<3cm). In group 3, 3cm or from 3cm to 4cm (3≤D<4cm). And in group 4, 4cm or lager (4cm≤D).
Results :. The mean age and tumor size were 68.0 ± 6.96 years and 1.5 ± 0.24 cm in group 1, 62.42 ± 11.77 years and 2.14 ± 0.16cm in group 2, 67.36 ± 12.39 years and 3.28 ± 0.29cm in group 3, 59.0 ± 15.29 years and 5.07 ± 1.66cm in group 4. The four groups were similar in age, sex, BMI, ASA, baseline renal function, hemoglobin, hospital stay showing no statistic difference, but operation time, estimated blood loss and complication were statistically different (p=0.045, 0.018 and 0.041). During the mean follow-up of 24.5 months, there were 6 complications in group 3 and 4 that were 5 postoperative transfusions and 1 conversion to open renal cryoablation. And there were 2 recurrences of tumor in group 4 (p=0.003).
Conclusions: LRC of renal tumors smaller than 3cm is effective without oncological recurrence and complication. LRC for renal tumors lager than 3cm in diameter is associated with higher transfusion rates. LRC for renal tumor lager than 4cm in diameter is associated with higher recurrence rates.
주제어
#Laparoscopic renal cryoablation Renal tumors Size of renal tumor
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