Abstract:
INTRODUCTION:Irreversible electroporation (IRE) is a non-thermal minimally invasive technique that is used to treat small renal masses (SRMs). Prior work has demonstrated greater narcotic requirements after radiofrequency ablation (RFA) for tumors that are closer to body-wall musculature. We hypothesized that pain after IRE is not dependent on tumor location due to the athermal mechanistic action. MATERIALS AND METHODS:A retrospective review of 50 consecutive percutaneous IRE and RFA cases was performed from 2013 to 2014. Eight patients were excluded from analysis due to incomplete anesthesia record and/or multiple ablations per session, leaving 21 patients in each group. Data collected included patient age, sex, body mass index, nephrometry score, shortest distance to the closest body-wall muscle, perioperative narcotic use, and patient-reported pain score. Pearson correlation test and multivariable linear regression were used to identify predictors of postoperative pain, with significance set at p = 0.05. RESULTS:There was no difference in the mean distance from tumor edge to the nearest body-wall muscle between IRE and RFA (2.6 cm vs 2.4 cm, p = 0.729, respectively). Total mean perioperative narcotic usage was 20.4 mg after IRE and 26.7 mg after RFA (p = 0.096). Mean postoperative pain score (scale 0-10) was slightly higher after RFA (4.3) compared with IRE (2.4), but this was not statistically significant (p = 0.088). Pearson correlation test identified tumor proximity to be significiantly associated with both pain score (p = 0.011) and postoperative narcotic use (p = 0.049) after RFA but not after IRE. On multivariable analysis, only tumor proximity to the body wall was significantly correlated to pain score (-1.4, p = 0.041) after RFA but was not found to be a factor for pain after IRE. CONCLUSIONS:Patients whose tumors lie close to their body-wall musculature do not have greater narcotic requirements or higher pain scores in the perioperative period after IRE. Percutaneous IRE may be preferred over RFA for SRMs that are close to the body wall to minimize pain.
journal_name
J Endouroljournal_title
Journal of endourologyauthors
Sorokin I,Lay AH,Reddy NK,Canvasser NE,Chamarthy M,Cadeddu JAdoi
10.1089/end.2017.0201subject
Has Abstractpub_date
2017-08-01 00:00:00pages
751-755issue
8eissn
0892-7790issn
1557-900Xjournal_volume
31pub_type
杂志文章abstract::This study aimed to measure acoustic access to the prostate for extracorporeal ultrasound ablation. Both transabdominal and transperineal approaches were considered. The objective was to measure the size and shape of the aperture available for unobstructed targeting of the prostate. CT images of 17 randomly selected m...
journal_title:Journal of endourology
pub_type: 杂志文章
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abstract:INTRODUCTION:Previous robot-assisted partial nephrectomy (RAPN) studies have identified various predictors of overall and major postoperative complications, but few have evaluated the specific role of these factors in the development of medical and surgical complications. In this study, we present an analysis of the mo...
journal_title:Journal of endourology
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journal_title:Journal of endourology
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doi:10.1089/end.2013.0214
更新日期:2013-09-01 00:00:00
abstract:PURPOSE:To evaluate contemporary management approaches to medium-sized (10-20 mm) renal stones. PATIENTS AND METHODS:A total of 935 patients treated for medium-sized renal stones (10-20 mm) between July 2012 and March 2014 were included in the study program. Contemporary minimally invasive approaches applied in the ma...
journal_title:Journal of endourology
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doi:10.1089/end.2014.0698
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journal_title:Journal of endourology
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journal_title:Journal of endourology
pub_type: 杂志文章,多中心研究
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abstract:BACKGROUND AND PURPOSE:Chronic unilateral hematuria is characterized by intermittent or continuous gross hematuria that cannot be diagnosed using standard radiology and hematology methods. In the past, it was managed with partial or total nephrectomy. In the age of minimally invasive procedures, however, endoscopy has ...
journal_title:Journal of endourology
pub_type: 临床试验,杂志文章
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pub_type: 传,历史文章,杂志文章
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journal_title:Journal of endourology
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journal_title:Journal of endourology
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journal_title:Journal of endourology
pub_type: 临床试验,杂志文章
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journal_title:Journal of endourology
pub_type: 临床试验,杂志文章
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更新日期:1998-08-01 00:00:00
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journal_title:Journal of endourology
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:2015-08-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
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