title: Ice burn: protecting the flank during renal cryotherapy.
abstract: OBJECTIVE
  Cryoablation is a viable minimally invasive strategy for the treatment of small renal masses. One of the most common postoperative complaints is pain or paresthesia at the cryoprobe insertion site. The use of a 14-gauge angiocatheter to insulate the flank during renal cryotherapy was investigated.
  
  
  METHODS
  Six Yorkshire swine underwent laparoscopy-guided percutaneous cryoablation of the upper and lower poles of both kidneys with a 1.47 mm (17 gauge) cryoneedle. Treatment consisted of a double 10-minute freeze separated by a 5-minute active thaw. Trials were randomized to placement of the cryoneedle directly through the flank or through a 14-gauge angiocatheter as an insulating sheath. Temperatures were recorded adjacent to the cryoneedle at two depths in the flank with a Multi-Point Thermal Sensor.
  
  
  RESULTS
  Twelve trials were completed each with a bare and sheathed cryoneedle. The coldest temperature observed was -26 degrees C for the bare cryoneedle and -21 degrees C for the sheathed cryoneedle. At the outer sensor, there was a 4.1 degrees C increase in mean temperature for freeze 1, and 6.2 degrees C increase in mean temperature for freeze 2 with sheath use. At the inner sensor, there was a 3.0 degrees C increase in mean temperature for freeze 1, and 9.4 degrees C increase in mean temperature for freeze 2 with sheath use. There was a trend toward statistical significance of sheath insulation at the outer (p = 0.07) and inner (p = 0.08) temperature sensors.
  
  
  CONCLUSIONS
  A 14-gauge angiocatheter may provide some insulation and thereby might help protect against "ice burn" during renal cryotherapy.
authors.affiliation: Department of Urology, University of California Irvine, Orange, California 92868, USA. jlyoung@uci.edu
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Young
authors.forename: Petros
authors.initials: P
authors.lastname: Sountoulides
authors.forename: Surendra B
authors.initials: SB
authors.lastname: Kolla
authors.forename: Donald L
authors.initials: DL
authors.lastname: Pick
authors.forename: Oskar B
authors.initials: OB
authors.lastname: Kaufmann
authors.forename: Victor B
authors.initials: VB
authors.lastname: Huynh
authors.forename: Adam G
authors.initials: AG
authors.lastname: Kaplan
authors.forename: Cervando
authors.initials: C
authors.lastname: Ortiz
authors.forename: Michael K
authors.initials: MK
authors.lastname: Louie
authors.forename: Lorena A
authors.initials: LA
authors.lastname: Andrade
authors.forename: Kathryn E
authors.initials: KE
authors.lastname: Osann
authors.forename: Elspeth M
authors.initials: EM
authors.lastname: McDougall
authors.forename: Ralph V
authors.initials: RV
authors.lastname: Clayman
mesh_terms: D000818:Animals; D001831:Body Temperature; D002056:Burns / Q000209:etiology* / Q000517:prevention & control*; D002404:Catheterization; D003452:Cryosurgery / Q000009:adverse effects*; D005615:Freezing; D007053:Ice; D007668:Kidney / Q000601:surgery*; D010535:Laparoscopy; D013552:Swine
chemical_list: D007053:Ice