title: Hydrodissection using an iodinated contrast medium during percutaneous renal cryoablation.
abstract: We describe our experience using an iodinated contrast solution to hydrodissect adjacent structures before percutaneous renal cryoablation. Hydrodissection was performed before cryoablation with placement of a 20-gauge, 15-cm introducer needle into the retroperitoneum under CT or ultrasonographic guidance followed by infusion of 5% dextrose in water and 2% iodinated contrast between the kidney and the adjacent organ. Ten patients underwent hydrodissection with an iodinated contrast solution at our institution. The mean tumor size was 3.1 ± 1.2 cm. The organs displaced included colon (n=7), small bowel (n=1), pancreas (n=1), and in one case, both the colon and ureter were displaced. The average displacement of all organs from the kidney was 2.8 cm (range 2.2-3.5 cm). There were no complications and no injuries to any adjacent structures. The injection of iodinated contrast allows for safe mobilization and differentiation of adjacent structures from the renal tumor and parenchyma leading to potentially safer cryoablation.
authors.affiliation: Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin 53705, USA.
authors.forename: Sutchin R
authors.initials: SR
authors.lastname: Patel
authors.forename: J Louis
authors.initials: JL
authors.lastname: Hinshaw
authors.forename: Meghan G
authors.initials: MG
authors.lastname: Lubner
authors.forename: Meghan G
authors.initials: MG
authors.lastname: Lubne
authors.forename: Fred T
authors.initials: FT
authors.lastname: Lee
authors.forename: Stephen Y
authors.initials: SY
authors.lastname: Nakada
authors.forename: Sean P
authors.initials: SP
authors.lastname: Hedican
mesh_terms: D003106:Colon / Q000601:surgery; D003287:Contrast Media; D003452:Cryosurgery / Q000379:methods*; D004210:Dissection / Q000379:methods*; D006801:Humans; D007455:Iodine; D007668:Kidney / Q000601:surgery*; D007680:Kidney Neoplasms / Q000601:surgery; D010179:Pancreas / Q000601:surgery; D014867:Water
chemical_list: D003287:Contrast Media; D014867:Water; D007455:Iodine