Renal cryoablation – does deep endophytic ablation affect the renal collecting system?
| Autor: | Ole Graumann, Hanne Vinter, Bodil Ginnerup, Malene B Aastrup, Michael Borre, Ahmad Makki, Tommy Kjærgaard Nielsen |
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| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Swine Renal cryoablation Urology medicine.medical_treatment Sus scrofa 030232 urology & nephrology Hemorrhage 030204 cardiovascular system & hematology Kidney urologic and male genital diseases Collection system Cryosurgery Necrosis PARTIAL NEPHRECTOMY 03 medical and health sciences 0302 clinical medicine renal collecting system medicine Animals Kidney Pelvis Urothelium business.industry Cryoablation Ablation Magnetic Resonance Imaging RADIO-FREQUENCY ABLATION treatment of renal cancer Nephrology CLOSURE business |
| Zdroj: | Makki, A, Aastrup, M B, Vinter, H, Ginnerup, B, Graumann, O, Borre, M & Nielsen, T K 2020, ' Renal cryoablation-does deep endophytic ablation affect the renal collecting system? ', Scandinavian Journal of Urology, vol. 54, no. 1, pp. 33-39 . https://doi.org/10.1080/21681805.2019.1702094 |
| ISSN: | 2168-1813 2168-1805 |
| Popis: | Objective: To investigate to what extent the urothelium of the renal collecting system is affected when performing deep endophytic cryoablation. Methods: The study was conducted as an in vivo animal model with a total of 15 female pigs. Each animal was subjected to bilateral endophytioc renal cryoablation and randomized to a postoperative follow-up period of either one, two or four weeks. At the end of follow-up all animals had a magnetic resonance imaging (MRI) examination and bilateral nephrectomy was performed. On MRI-imaging the extent of the cryolesions, as well as signs of urinomas or fistulas, were examined. Histopathologic examinations were performed to investigate the effect on the urothelium. Results: All animals tolerated the procedure well without any postoperative complications. MRI examinations found the renal collecting system to be involved in the cryolesions at all three stages of follow-up and revealed no signs of hematomas, urinomas or fistula formations. Epithelial edema was found at all three stages of follow-up while significant parenchymal fibrosis adjacent to the urothelium was most pronounced in the four weeks of follow-up group. The urothelium was significantly affected with luminal hemorrhage as well as hemorrhage in and underneath the urothelium and urothelial dissociation from the underlying renal parenchyma. Despite these impacts on the urothelium, this was found to be intact and vital at all three stages of follow-up, in sharp contrast to the renal parenchyma that underwent fibrotic changes. Conclusions: In this, in vivo non-tumor pig model CA effectively destroyed the renal parenchyma while the impacted renal urothelium remained intact and did not undergo fibrotic changes, nor was urinomas or fistulas observed. |
| Databáze: | OpenAIRE |
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