Laparoscopic renal cryoablation: impact on renal function and blood pressure.
OBJECTIVE
To evaluate the renal function and blood pressure outcomes after laparoscopic renal cryotherapy. Laparoscopic renal cryoablation is a developmental minimally invasive modality for the treatment of renal neoplasms. After cryotherapy, a segment of renal parenchyma is rendered ischemic/necrotic and left in situ. It is currently unknown whether this may trigger renin overproduction and thus renin-mediated hypertension.


METHODS
Data are presented for 22 of 56 treated patients, each of whom completed a minimum follow-up of 6 months. The data were obtained from patient charts, phone interviews, and/or questionnaires. These results were statistically compared over time by paired t tests.


RESULTS
The mean follow-up was 20.6 months. No significant differences were found between the preoperative and most recent postoperative serum creatinine (sCr) levels (1.13 and 0.91 mg/dL, respectively), systolic and diastolic blood pressure values (135.6 versus 131.2 mm Hg and 78 versus 72.7 mm Hg, respectively), or in the estimated creatinine clearance (P <0.05). The number or dose of antihypertensive medications did not change during the follow-up period for any patient. In 3 patients with a solitary kidney, the blood pressure and sCr values remained unchanged (mean preoperative sCr 1.43 mg/dL and mean postoperative sCr after a minimum of 6 months 1.33 mg/dL).


CONCLUSIONS
Laparoscopic renal cryoablation did not have a deleterious impact on renal function or blood pressure during a mean follow-up of 20.6 months.
Carvalhal
E F
EF
Section of Laparoscopic and Minimally Invasive Surgery, Urological Institute, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Gill
I S
IS
Meraney
A M
AM
Desai
M M
MM
Schweizer
D K
DK
Sung
G T
GT
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000706:statistics & numerical data; D003404:Creatinine / Q000097:blood; D003452:Cryosurgery / Q000009:adverse effects / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy; D007668:Kidney / Q000502:physiology* / Q000601:surgery; D007677:Kidney Function Tests / Q000706:statistics & numerical data; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D011184:Postoperative Period; D012189:Retrospective Studies; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D003404:Creatinine