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    Korean J Urol. 2006 Mar;47(3):244-251. Korean.
    Published online Mar 31, 2006.
    https://doi.org/10.4111/kju.2006.47.3.244
    Copyright © 2006 The Korean Urological Association
    Original Article

    Initial Experience of Radiofrequency Ablation of Renal Tumor

    June Heo, Sung Kuk Yun,1 and Gyung Tak Sung
      • Department of Urology, Dong-A University School of Medicine, Busan, Korea.
      • 1Department of Diagnostic Radiology, Dong-A University School of Medicine, Busan, Korea.
    • Corresponding author (Email: sunggt@daunet.donga.ac.kr )
    Received August 09, 2005; Accepted January 25, 2006.

    Abstract

    Purpose

    We wanted to report the our early experience with performing nephron-sparing radiofrequency ablation (RFA) of renal tumor.

    Materials and Methods

    Three percutaneous RFAs were performed under combined computed tomography (CT) and ultrasonogram guided, and two intraoperative ultrasonograpy-guided laparoscopic RFAs were performed since June 2004. The treatment indications were localized, small (<4cm), solid renal masses in elderly patients and also the same type masses in the patients with comorbid conditions. The follow-up studies included physical examination, CBC, serum creatinine, urine analysis and kidney CT, and these were performed at day 1, 1 week, 1 month, 3 months, 6 months and 1 year after ablation, and then semi-annually thereafter. The mean follow-up duration was 8.8 months (range: 5-12 months).

    Results

    All five patients underwent successful RFA without any serious events. One patient had a mild perinephric hematoma and another patients had mild gross hematuria postoperatively. With a mean follow-up of 8.8 months, none of the patients showed any residual tumor on follow-up contrast-enhanced CT after the final tumor ablation. Complete tumor ablation was achieved after a single treatment session in 80% of the patients and in 20% of patients after the subsequent ablation sessions.

    Conclusions

    Percutaneous or laparoscopic RFA is a promising nephron-sparing treatment for selected patients with small renal mass. Contrast-enhanced CT performed immediately after ablation is a reliable method to exclude residual viable tumor. The ultimate role for this modality will continue to evolve and this warrants further studies.

    Keywords
    Radiofrequency ablation; Nephrons; Laparoscopy

    Figures

    Fig. 1
    Cool tip needle radiofrequency ablation (RFA) machine (Cool-tip™ RF ablation System; Radionics, Tyco, USA).

    Fig. 2
    Percutaneous radiofrequency ablation (RFA). (A) Computed tomogram guided image access of the renal tumor on the lateral position. (B) Percutaneous RFA needle insertion.

    Fig. 3
    (A) Placement of the ports during the laparoscopic radiofrequency ablation (RFA) on the left renal tumor. (B) Laparoscopic real time ultrasound guided RFA needle insertion into the renal tumor through Gerota's fascia is shown.

    Fig. 4
    (A) Transverse kidney computed tomography (CT) image prior to radiofrequency ablation (RFA) shows a 2cm sized right posterior middle-pole renal mass. (B) Transverse kidney CT image obtained 1 month after RFA shows no contrast enhancement of the right renal tumor. (C) Another transverse image of post-RFA shows the perinephric hematoma that appeared 1 month after the RFA procedure in case 2.

    Tables

    Table 1
    The patient's characteristics and pre-operative status of 5 cases

    Table 2
    Results of radiofrequency ablation in 5 patients

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    MeSH Terms
    Aged
    Catheter Ablation*
    Creatinine
    Follow-Up Studies
    Hematoma
    Hematuria
    Humans
    Kidney
    Laparoscopy
    Neoplasm, Residual
    Nephrons
    Physical Examination
    Tomography, X-Ray Computed
    Ultrasonography
    Metrics
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