Laparoscopic and percutaneous cryotherapy for renal neoplasms

Incidence of renal cell carcinoma is increasing. There has been a shift towards utilization of nephron sparing surgery when feasible. Minimally invasive ablative treatments such as laparoscopic and percutaneous renal cryoablation aim to treat renal tumors with the two goals of cancer eradication and reduced morbidity compared to excisional surgical approaches. In this article, we review the basis of cryobiology and examine the current role of renal cryoablation and analyze the current literature focusing on laparoscopic and percutaneous approaches and discuss future directions and refinements in cryosurgical technology. While renal cryoablation is associated with higher local retreatment rates compared to radical or partial nephrectomy, emerging reports of intermediate-term oncological outcomes suggest disease-specific survival approaching that of extirpative surgery. Further follow up is needed to elucidate the long-term oncologic outcomes of and effects on renal function by renal cryoablation.