Ice burn: protecting the flank during renal cryotherapy.
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.
Young
Jennifer L
JL
Department of Urology, University of California Irvine, Orange, California 92868, USA. jlyoung@uci.edu
Sountoulides
Petros
P
Kolla
Surendra B
SB
Pick
Donald L
DL
Kaufmann
Oskar B
OB
Huynh
Victor B
VB
Kaplan
Adam G
AG
Ortiz
Cervando
C
Louie
Michael K
MK
Andrade
Lorena A
LA
Osann
Kathryn E
KE
McDougall
Elspeth M
EM
Clayman
Ralph V
RV
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
D007053:Ice