Lapraroscopy-assisted cryotherapy for small renal tumours

B80: Lapraroscopy-assisted cryotherapy for small renal tumours Baum P., Kukk L., Valk E., Zirel Y. North Estonian Medical Centre, Dept. of Urology, Tallinn, Estonia INTRODUCTION & OBJECTIVES: Laparoscopic cryoablation has been proposed as a minimally invasive nephron-sparing treatment for selected patients. We report on our experience with a laparoscopic technique using multiple 1,5mm ultrathin cryoprobes. MATERIAL & METHODS: Since May 2008, a Laparoscopy-assisted cryoablation has been performed in 22 patients with a solid renal tumor without radiological evidence for involvement of the collecting system. Mean tumor size on the CT scan was 2,6 (1,6- 4,0) cm. A double freeze-thaw cycle of renal cryoablation was performed under realtime ultrasound monitoring. RESULTS: Cryosurgery was successfully performed in all 22 patients with 18 patients undergoing assisted retroperitoneoscopy and 4 patients with assisted transperitoneal laparoscopic approach. Mean duration of surgery was 110 (80- 185) minutes and mean blood loss was 75 (50–200) ml. Intraoperative biopsy of the tumor confirmed renal cell carcinoma in sixteen patients, and oncocytoma in three patients; it was inconclusive in three cases. Mean patient age was 66 yr (range: 33–82), and 10 left and 12 right kidneys were treated. The only intraoperative complication was bleeding after removal of the cryoprobes in one patient. Three of our patients presented postoperative complications: one patient with significant haematuria managed by ureteral stent, one patient with episode of cardiac arrhythmia and one patient needed a blood transfusion postoperatively. No other complications were observed. During mean follow-up of 34 months (range: 2-69 mo) one patient had histologically proven local recurrence, all other 21 patients remained without evidence of local recurrence. One patient died from unrelated disease and one patient with previous contralateral nephrectomy for RCC developed metastatic disease without recurrence in the cryoablated kidney. CONCLUSIONS: Laparoscopy-assisted cryotherapy for small renal tumors is safe and effective with encouraging oncologic results on intermediate term follow-up. Eur Urol Suppl 2014; 13(2): e1198

e1198