Abstract:
BACKGROUND AND PURPOSE:Cryoablation has demonstrated therapeutic effectiveness for selected renal tumors. We compared our perioperative and short-term outcomes of laparoscopic (LAP) v percutaneous (PERC) renal cryoablation. PATIENTS AND METHODS:Thirty-four patients (18 men/16 women) underwent a LAP and 26 patients (19 men/7 women) underwent a PERC procedure between September1998 and January 2007. LAP cryoablation was performed transperitoneally with ultrasonographic monitoring. PERC cryoablation was performed with CT guidance. Follow-up imaging was obtained at regular intervals. RESULTS:Mean follow-up was 25 months. Average age (years) was 67.0 for the LAP and 69.7 for the PERC procedure (P = 0.307). Mean body mass index (kg/m(2)) was 29.8 for those undergoing LAP and 28.7 for those undergoing PERC procedures (P = 0.543). Mean tumor size (cm) was 2.9 for LAP patients and 3.1 for PERC patients (P = 0.432). Anterior tumors comprised 61.7% of LAP and 15.4% of PERC procedures (P < 0.001). Posterior tumors comprised 32.4% of LAP and 65.4% of PERC procedures (P = 0.01). Mean procedure time (minutes) was 165.7 for LAP and 106.6 for PERC procedures (P < 0.001). Hospital stay (days) was 2.6 for those undergoing LAP and 1.8 for those undergoing PERC procedures (P < 0.001). Both LAP patients (82.4%) and PERC patients (19.2%) needed postoperative narcotics (P < 0.001). Atelectasis developed in 70.6% of LAP patients and 34.6% of PERC patients (P = 0.005). Residual enhancement was seen in 11.5% of PERC patients and 2.9% of LAP patients (P = 0.192). Complications developed in 14.7% of LAP patients and 26.9% of PERC patients (P = 0.248). 1-year, 2-year, and 3-year disease-specific survival for the two groups was 100%. Tumor size > 4 cm and endophytic location were significantly associated with residual enhancement. CONCLUSIONS:LAP and PERC renal cryoablation have similar short-term outcomes. Significantly more anterior tumors were approached laparoscopically and significantly more posterior tumors were approached percutaneously. The PERC approach may offer advantages regarding hospital stay, narcotic need, and development of atelectasis. Longer-term data are needed to establish success of this approach.
journal_name
J Endouroljournal_title
Journal of endourologyauthors
Derweesh IH,Malcolm JB,Diblasio CJ,Giem A,Rewcastle JC,Wake RW,Patterson AL,Gold Rdoi
10.1089/end.2008.0196subject
Has Abstractpub_date
2008-11-01 00:00:00pages
2461-7issue
11eissn
0892-7790issn
1557-900Xjournal_volume
22pub_type
杂志文章abstract:PURPOSE:To evaluate the utility of two ipsilateral ureteral stents placed for benign and malignant ureteral obstruction. METHODS:We performed a retrospective analysis of all cases of tandem ureteral stent (TUS) insertion at our institution from July 2007 through January 2013. Student t, Fisher exact, and log-rank test...
journal_title:Journal of endourology
pub_type: 杂志文章
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更新日期:2013-10-01 00:00:00
abstract::This is a case report of a 37-year-old man with severe testicular pain unresolved after conventional investigative and therapeutic methods. On the basis of his history of abdominal trauma followed by emergency splenectomy and evidence of functioning splenic tissue on a radionuclide scan, the diagnosis of splenosis was...
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abstract:OBJECTIVE:To evaluate perioperative morbidity and mortality rate, a 3-year recurrence-free survival, and cancer-specific mortality rate in patients older than 80 years undergoing robot-assisted radical cystectomy (RARC). MATERIALS AND METHODS:We retrospectively collected data of 155 consecutive patients who received R...
journal_title:Journal of endourology
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更新日期:2016-07-01 00:00:00
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journal_title:Journal of endourology
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journal_title:Journal of endourology
pub_type: 杂志文章
doi:10.1089/end.1994.8.345
更新日期:1994-10-01 00:00:00
abstract::Laparoscopic pyeloplasty represents one of the more advanced reconstructive procedures for the urologist. While early reports were replete with long operative times, there have been several changes that have added to the efficiency of the procedure. In our practice, we have found three changes to be of greatest value:...
journal_title:Journal of endourology
pub_type: 杂志文章,评审
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journal_title:Journal of endourology
pub_type: 杂志文章,meta分析,评审
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更新日期:2012-11-01 00:00:00
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pub_type: 杂志文章
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更新日期:2014-07-01 00:00:00
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journal_title:Journal of endourology
pub_type: 杂志文章
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journal_title:Journal of endourology
pub_type: 杂志文章
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journal_title:Journal of endourology
pub_type: 杂志文章
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更新日期:2018-12-01 00:00:00
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journal_title:Journal of endourology
pub_type: 杂志文章
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pub_type: 杂志文章
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journal_title:Journal of endourology
pub_type: 杂志文章
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journal_title:Journal of endourology
pub_type: 杂志文章
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pub_type: 杂志文章,评审
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更新日期:2004-09-01 00:00:00
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更新日期:2011-11-01 00:00:00