Energy ablative techniques for treatment of small renal tumors.
OBJECTIVE
The success of partial nephrectomy for the treatment of small renal cancers has led to the development of energy ablative technologies, which are less invasive alternatives for performing nephron-sparing surgery. Currently, cryoablation and radiofrequency ablation are the two most reported technologies. Both technologies use very different means to cause cellular injury. Additionally, three newer technologies, high-frequency ultrasound ablation, laser interstitial therapy, and microwave therapy are emerging in the literature.


RESULTS
Three- and 4-year data for cryoablation and radiofrequency ablation are now becoming available. On the basis of these studies, it is clear that ablative technologies can be effective treatments for select small renal tumors. It is also evident that both percutaneous and laparoscopic approaches offer minimal morbidity.


CONCLUSIONS
As long-term (5 years and greater) outcome data for ablative technologies accumulate, we are likely to see an increase in clinical reports, including more patients who may be candidates for extirpative surgery. Technology will advance, leading to smaller probes with larger treatment zones, making it possible to treat larger tumors and potentially even tumors in the advanced disease state.
Wen
C Charles
CC
Division of Urology, Department of Surgery, University of Wisconsin-Madison Medical School, Madison, Wisconsin 53792, USA.
Nakada
Stephen Y
SY
D017115:Catheter Ablation / Q000379:methods*; D003452:Cryosurgery / Q000379:methods*; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery* / Q000628:therapy; D053685:Laser Therapy / Q000379:methods; D008872:Microwaves / Q000627:therapeutic use; D014464:Ultrasonic Therapy / Q000379:methods