Percutaneous cryoablation of renal tumours: complications based on own material

Partial nephrectomy (PN) is the primary treatment for T1 renal cell carcinoma (RCC). Also, percutaneous cryoablation is gaining attention as a curative option in appropriately selected patients. However, even mini-mally invasive procedures are not free from toxicity. The objective of this study was to assess the safety profile of the percutaneous renal cryoablation (PCA) procedure during the learning curve of the first 75 cases.

All procedures were performed by urologists with vast experience in ultrasonography (USG)-guided percutaneous renal procedures and interventional radiologists skilled in computed tomography (CT) interventions. The cryoprobes were inserted percutaneously under hybrid USG/intermittent CT guidance. Complications that took place in the first 4 weeks after the procedure, both during hospitalisation and after discharge, were evaluated.

The study included 68 patients with 75 tumours treated with PCA in our centre. The patients were old (mean 72 years), overweight (mean BMI 29.1) and severely comorbid (aver-age Charlson comorbidity index 5.9; ASA score 2.8). Pain during the surgery was reported by 21.3% of the patients. Five (6.7%) perirenal haematomas > 4 cm developed immediately after the surgery. The most common postoperative ailments included: ma-laise (20.0%), pain (16.0%), nausea and vomiting (8.0%) and haematuria (6.7%). Other complications occurred in less than 5% of the cases. Nonetheless, no blood transfusions were neces-sary and only one patient required a minor surgical intervention.

According to this study, PCA is a safe procedure with a very low risk of major complications.