NEW ORLEANS, LA USA (UroToday.com) - Introduction and Objectives: Percutaneous renal cryoablation (PRC) has emerged as a promising treatment modality for small renal cortical neoplasms.
PCR was originally performed with patients under general anesthesia (GA). However, the use of local anesthesia with conscious sedation (LACS) is now an option. We compared the efficacy and safety of LACS and GA general in patients undergoing PRC.
Methods: We performed a retrospective multi-center review of patients undergoing PRC between 2003 and 2013 at two academic institutions. Patient demographics, tumor characteristics, peri-operative, postoperative and follow-up data were recorded and reviewed.
Results: A total of 235 patients with available data were included in our analysis. Of these, 82 patients underwent PRC under GA and 153 patients under LACS. The two groups were similar with regard to age, gender, BMI, ASA Score, tumor size, polarity, location and depth, preoperative serum creatinine and hematocrit. The mean procedure time for LACS was significantly less compared to GA (102 vs. 133 minutes, P < 0.001). The mean hospital stay was shorter under LACS (1.08 vs. 1.95 days, P < 0.0001). The mean follow-up time for LACS and GA was 21 and 37 months, respectively (P < 0.0001). There was no difference in treatment-related complications and postoperative serum creatinine and hematocrit. Both groups had a similar percentage of patients with biopsy proven renal cell carcinoma (64.2% and 68.5% in the LACS and GA, respectively, P = 0.621). There was no difference in immediate or delayed failures between LACS and GA (1.9% and 3.9%; 0 and 11%, respectively, P = 0.051).
Conclusions: Percutaneous renal cryoablation for small renal masses under LACS is effective and safe. Our data shows that LACS has the advantage of decreased procedure time and a shorter hospital stay. Prospective randomized studies are needed to confirm these preliminary findings.
Source of Funding: none
Click HERE to listen to Martin Hofmann speak about the study
Presented by: Martin Hofmann,a Samuel Juncal,a Zhamshid Okhunov,a Arvin K. George,b Michael Ordon,a Achim Lusch,a Philip Bucur,a Fatima K. Askarova, Louis Kavoussi,b Cassio Andreoni,c and Jaime Landmana at the 31st World Congress of Endourology (WCE) - October 22 - 26, 2013 - New Orleans, LA USA
aDepartment of Urology, University of California, Irvine, USA. bThe Arthur Smith Institute for Urology, Hofstra North Shore-LIJ School of Medicine, USA. cDepartment of Urology, Federal University of São Paulo, Brazil
Beyond the Abstract