Percutaneous Radiofrequency Ablation of the RenalTumors. Initial Clinical Experience with Minimally Invasive Therapy

Souhrn

Aim of the article:
To evaluate first clinical and interventional radiological features and experience with computed tomography-guided percutaneousradiofrequency ablation of the renal tumors using StarBurst instruments (RITAMedical System, Inc., Mountain View, CA).Methods: The group of 8 patients with mean age 77.75 ± 4.38 years underwent during a period of 12 months CT-guided RFA treatmentsfor enhancing renal masses, with a mean size 21.78 ± 9.81 mm, using only conscious sedation and local anaesthesia. All patientshad multiple medical comorbidities that limited or completely contraindicated surgical treatment. In two cases tumors involved solitarykidney. Patients were hospitalized in urologic department of University hospital, where possible early complications were monitored. Patientswere followed with clinical status and renal function studies. Also enhanced imaging (enhanced computed tomography or magneticresonance in one case) were performed 1 month, 3, 6 and 12 months after initial procedure. Successful ablation was defined as a lack ofenhancement of the renal mass eventually with a scar-like retraction of surrounding renal parenchyma.Results: During a 12-months period (from February 2006 to February 2007) 10 percutaneous CT-guided RFA treatments in 8 patientswere performed. In 6 patients (75%) were single treatment successful, 1 had an initial failure and underwent reablation successfully and1 underwent second treatment for coexisting small tumor in the same kidney. All patients stayed in hospital for a 3 days, none from thisgroup died during this period and none need not to be excluded from this study. We did not reveal any early complication. Average lengthof the following-up was 5.75 months.Conclusions: CT-guided percutaneous radiofrequency ablation is a promising therapeutic alternative of surgical methods (nephrectomiesor nephron-sparing surgical devices) especially with small renal tumors in patients with multiple medical comorbidities, tumors insolitary kidneys and in rarer indications. The procedure were well tolerated using only conscious sedation and local anaesthesia. Noneearly complication was observed. Other useful informations will be probably captured by following-up this group and by monitoring newpatients.

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