LAPAROSCOPIC CRYOABLATION OF RENAL TUMORS: INITIAL EXPERIENCE

With the widespread use of x-ray imaging, echography, computerized tomography, magnetic resonance imaging, diagnosis of small kidney malignancies as well as renal cell carcinoma have increased. Surgical treatment of renal tumors with clinical cT1b stage is the radical nephrectomy. Partial nephrectomy is considered to be a gold standard in the surgical treatment of small kidney masses in stage 1 cT1b. However, treatment guidelines have recently changed in patients with renal tumors with cT1b. When establishing a patient with renal tumor in the cT1b stage the first treatment line should be partial nephrectomy. Partial nephrectomy is associated with perioperative complications in about 20% of cases, which causes significant comorbidity. Following the introduction of renal cryoablation at the end of the 1990s, urologists broadened the role of cryoablation to treat cT1b stage tumors in selected patients. Renal cryoablation is a recommended therapeutic alternative in a specific patient population, namely elderly patients, patients with multiple concomitant diseases, single kidney patients, ipsilateral multiple kidney tumors or patients with bilateral renal tumors. Laparoscopic renal cryoablation appears as an option for the treatment of small kidney masses due to a less invasive procedure with low intraoperative complications, without impairment of normal renal parenchyma, and has good comparable mid-term outcomes on follow-up studies. The purpose of this report is to analyze our initial clinical experience with laparoscopic cryoablation of kidney tumors and to investigate how effective and safe this method is.