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Laparoscopic cryotherapy for small renal masses: Current State.

E R Cordeiro¹, K Barwari, A Anastasiadis

¹Servicio de Urologúa, Hospital AMC, Amsterdam, Holanda. ercordeiro@hotmail.com

Archivos Espanoles De Urologia

|February 15, 2013

Summary

Laparoscopic cryoablation (LCA) for small renal masses (SRMs) shows acceptable 3- to 5-year oncological outcomes with low recurrence rates. This safe procedure is indicated for elderly patients with high surgical risks.

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Area of Science:

Urology
Minimally Invasive Surgery
Oncology

Background:

Small renal masses (SRMs) are increasingly detected, necessitating effective and safe treatment options.
Laparoscopic cryoablation (LCA) has emerged as a minimally invasive technique for managing SRMs.

Purpose of the Study:

To review the literature on laparoscopic cryotherapy for SRMs.
To describe the technique, indications, and outcomes of LCA for SRMs.

Main Methods:

A systematic literature search was conducted in March 2012.
Included studies were English-language, human-based full manuscripts reporting case series with >20 participants, efficacy, and safety data.
MEDLINE and EMBASE databases were utilized for the search, covering the last 10 years.

Main Results:

27 full reports on LCA for SRMs were selected; no RCTs were identified.
Mean patient age was 62-73 years, with mean tumor size of 2.7-4 cm (mostly <3 cm).
Persistence rates ranged from 0-17%, recurrence rates from 0-14%, and complication rates from 0-40% across studies with follow-up up to 93 months.

Conclusions:

LCA of SRMs demonstrates acceptable 3- to 5-year oncological outcomes with a low recurrence rate.
The procedure is safe with an overall low complication rate.
LCA is primarily indicated for SRMs in elderly patients with comorbidities and high surgical risk.