Laparoscopic cryoablation under sonographic guidance for the treatment of small renal tumors

Purpose: To evaluate the efficacy of ultrasound-guided laparoscopic cryoablation of small renal tumors. Patients and Methods: Eleven men and five women with solid renal tumors (mean size 2.6 cm) were treated using laparoscopically monitored cryoablation between October 2000 and October 2002. Nine tumors were left sided and seven right. Ten patients were treated retroperitoneoscopically and six transperitoneally. A double-freeze/active-thaw technique was utilized with two 10-minute freeze, cycles. Results: The mean operating time was 188 minutes. There was one open conversion for failure to progress. The mean blood loss was 40 mL. Tumor biopsy demonstrated five renal-cell carcinomas, two oncocytomas, and lesions that either were benign or were not biopsied. The mean hospital stay was 1.9 days with a median stay of 1 day. With a mean follow-up of 9.6 months, all tumors remain nonenhancing and are stable or smaller than the original lesion. Two patients have died of unrelated causes and without evidence of disease. Conclusions: This series of patients adds to the growing body of literature suggesting that cryoablation is a well-tolerated method for treating small renal tumors. Longer follow-up is required to fully define its place in the therapeutic armamentarium.