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Laparoscopic cryotherapy for pediatric angiomyolipoma: the first report
Antoine Leflore1, Patrick H McKenna, Bradley F Schwartz
1Center for Laparoscopy and Endourology, Southern Illinois University School of Medicine, Springfield, Illinois 62794-0665, USA.
Background And Purpose:
Renal cryotherapy for pediatric angiomyolipoma has never been reported in the literature. We present the first experience with this procedure, describing techniques and short-term outcome.
Case Report:
A 14-year-old girl was being followed for a 2-cm left renal angiomyolipoma. Growth was demonstrated by ultrasonography and CT imaging over a 2-year period, and the family desired intervention. A transperitoneal approach employing three 5-mm laparoscopic ports was used. Tumor size was measured by intraoperative ultrasonography as 25 x 28 mm. Intraoperative biopsy was done with a biopsy gun through the lateral port. An 8-mm cryoprobe was utilized. Two freeze-thaw cycles were performed with cooling to -160 degrees C. Hemostasis was accomplished with thrombin (FloSeal) and oxidized cellulose (Surgicel).
Results:
The operative time was 92 minutes, and the blood loss was minimal. No perioperative complications occurred. There was mild perioperative hematuria that resolved within 20 hours without stenting. The hospital stay was 46 hours. There were no complications or hematuria at 1-week postoperative follow-up.
Conclusion:
Laparoscopic cryotherapy can be performed in the pediatric population. To our knowledge, this is the first case of pediatric renal angiomyolipoma managed with laparoscopic cryotherapy.
