腹腔镜肾冷冻消融（LRC）18MB

How I Do It- Laparoscopic Renal Cryoablation (LRC)

Rodrigo Donalisio da Silva, MD, Paulo Jaworski, MD,
Diedra Gustafson, BS, Leticia Nogueira, Francis Kang, MD,
Wilson Molina, MD, Fernando J. Kim, MD


Recently, diagnoses of small renal masses and renal cell
carcinoma (RCC) have increased due to the widespread use
of radiographic imaging studies (computerized tomography,
magnetic resonance imaging). It appears that biological
factors such as obesity and tobacco use increase the risk for
RCC. In general, small malignant renal masses are low
stage and low grade. The management of asymptomatic
renal masses is a surgical challenge since overtreatment of
benign masses is not desired, especially for patients with
complex medical comorbidities, elderly patients, and those
with impaired renal function.
Partial nephrectomy has been considered the gold standard
when treating small renal masses. However, technical
challenges and possible irreversible ischemia-reperfusion
injury should be considered when treating these lesions.
Preservation of renal function without compromising
oncological control is the foundation for nephron-sparing
surgery. Laparoscopic renal cryoablation (LRC) emerges as
an option to treat small renal masses due to the less invasive
procedure with low intraoperative complications rates,
with no renal ischemia-reperfusion injury and comparable
medium term follow up. It is our objective to demonstrate
our technique to perform an effective small renal tumor
cryoablation using the laparoscopic approach

© The Canadian Journal of Urology™; 21(6); December 2014