Radiofrequency ablation of renal tumors with an expandable multitined electrode: results, complications, and pilot evaluation of cooled pyeloperfusion for collecting system protection

Autor: Albert Gelet, F.J. Murat, Marc Colombel, Xavier Martin, Lionel Badet, Olivier Rouvière, J.M. Marechal, Denis Lyonnet
Přispěvatelé: Applications des ultrasons à la thérapie, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Institut de biologie et chimie des protéines [Lyon] (IBCP), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Laboratoire des Mécanismes et Transfert en Géologie (LMTG), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Observatoire Midi-Pyrénées (OMP), Météo France-Centre National d'Études Spatiales [Toulouse] (CNES)-Université Fédérale Toulouse Midi-Pyrénées-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Météo France-Centre National d'Études Spatiales [Toulouse] (CNES)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Centre National de la Recherche Scientifique (CNRS), Service d'urologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL)
Jazyk: angličtina
Rok vydání: 2008
Předmět:
Male
Radiofrequency ablation
medicine.medical_treatment
030232 urology & nephrology
MESH: Kidney Pelvis
Pilot Projects
MESH: Risk Assessment
030218 nuclear medicine & medical imaging
law.invention
0302 clinical medicine
law
Renal cell carcinoma
Hypothermia
Induced
Kidney Pelvis
Intraoperative Complications
MESH: Treatment Outcome
MESH: Aged
MESH: Middle Aged
Ultrasound
Equipment Design
MESH: Neoplasm Staging
MESH: Carcinoma
Renal Cell
MESH: Follow-Up Studies
Middle Aged
Ablation
Nephrectomy
Kidney Neoplasms
3. Good health
Perfusion
Treatment Outcome
surgical procedures
operative
MESH: Survival Analysis
Catheter Ablation
MESH: Intraoperative Complications
Female
[SDV.IB]Life Sciences [q-bio]/Bioengineering
Radiology
Cardiology and Cardiovascular Medicine
MESH: Perfusion
Ablation zone
Glomerular Filtration Rate
Adult
medicine.medical_specialty
MESH: Probability
Risk Assessment
MESH: Multivariate Analysis
03 medical and health sciences
Carcinoma
medicine
Humans
Radiology
Nuclear Medicine and imaging
Carcinoma
Renal Cell
Electrodes
Aged
Neoplasm Staging
Probability
Retrospective Studies
MESH: Hypothermia
Induced
MESH: Humans
MESH: Catheter Ablation
business.industry
Retrospective cohort study
MESH: Adult
MESH: Retrospective Studies
MESH: Electrodes
medicine.disease
MESH: Pilot Projects
Survival Analysis
MESH: Male
Surgery
MESH: Glomerular Filtration Rate
Multivariate Analysis
MESH: Kidney Neoplasms
business
MESH: Female
Follow-Up Studies
MESH: Equipment Design
Zdroj: CardioVascular and Interventional Radiology
CardioVascular and Interventional Radiology, Springer Verlag, 2008, 31 (3), pp.595-603. ⟨10.1007/s00270-007-9291-3⟩
ISSN: 0174-1551
1432-086X
Popis: International audience; The objective of this study was to retrospectively evaluate the results of radiofrequency ablation (RFA) of renal tumors with an impedance-based system using an expandable multitined electrode. Twenty-two patients (30 tumors) were treated with RFA over a 7-year period, percutaneously (16 tumors) or intraoperatively (14 tumors). Follow-up imaging was performed at 1-3, 6, and 12 months and yearly thereafter. Twenty-seven of 30 tumors (19/22 patients) showed no residual tumor on the first imaging control. Two residual tumors were successfully ablated by a second RFA procedure. Our mean follow-up period was 35 months (range, 3-84 months). Two tumors that had been completely ablated based on imaging criteria recurred 11 and 48 months after RFA. One was treated by partial nephrectomy. The other one was not treated because the patient developed bone metastases. One patient had nephrectomy because of an RFA-induced ureteropelvic junction stricture. Nine patients (11 sessions) had a pyeloperfusion of cooled saline during RFA. None developed symptomatic complications, even though in three patients the ablation zone extended to the closest calyx (3-5 mm from the tumor). We conclude that RFA of renal tumors is promising, but serious complications to the collecting system must be taken into consideration. Prophylactic per-procedural cooling of the collecting system is feasible but needs further assessment.
Databáze: OpenAIRE
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