Minimally invasive surgery using ablative modalities for the localized renal mass.
Due to a number of evolving devices and modalities to treat the small, localized renal mass, the physician and patient have the opportunity to choose an appropriate therapy from several treatment options. Minimally invasive surgery to ablate a localized renal tumor is an alternative strategy to nephron-sparing surgery for the small renal mass. Even though partial nephrectomy has been established as an optimal technique for nephron-sparing surgery, patients who have comorbidities and renal insufficiency would potentially benefit from less invasive treatment. With respect to those concerns, several articles are discussed here regarding thermal ablative therapy for the small renal mass along with oncological outcomes and complications among these modalities compared to conventional procedures. In this review, a comprehensive PubMed search was conducted. For the purposes of reviewing the current status of thermal ablative modalities for the small renal mass, only articles written in English published from 1992 to 2009 were considered. Cryoablation and radiofrequency ablation are the most utilized and potentially promising therapies that are evolving as nephron-sparing minimally invasive surgery for patients with a localized renal tumor. High-intensity focused ultrasound, a relatively new modality to treat the renal mass, needs further study. All modalities require long-term follow up with unified reporting methods in terms of patient selection, pre- and post-treatment evaluation, treatment description, and analysis of outcome.
Kimura
Masaki
M
Division of Urologic Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.
Baba
Shiro
S
Polascik
Thomas J
TJ
D002292:Carcinoma, Renal Cell / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D003452:Cryosurgery / Q000379:methods*; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*