title: How I do it: laparoscopic renal cryoablation (LRC).
abstract: Recently, diagnoses of small renal masses and renal cell carcinoma (RCC) have increased due to the widespread use of radiographic imaging studies (computerized tomography, magnetic resonance imaging). It appears that biological factors such as obesity and tobacco use increase the risk for RCC. In general, small malignant renal masses are low stage and low grade. The management of asymptomatic renal masses is a surgical challenge since overtreatment of benign masses is not desired, especially for patients with complex medical comorbidities, elderly patients, and those with impaired renal function. Partial nephrectomy has been considered the gold standard when treating small renal masses. However, technical challenges and possible irreversible ischemia-reperfusion injury should be considered when treating these lesions. Preservation of renal function without compromising oncological control is the foundation for nephron-sparing surgery. Laparoscopic renal cryoablation (LRC) emerges as an option to treat small renal masses due to the less invasive procedure with low intraoperative complications rates, with no renal ischemia-reperfusion injury and comparable medium term follow up. It is our objective to demonstrate our technique to perform an effective small renal tumor cryoablation using the laparoscopic approach.
authors.affiliation: Division of Urology, Denver Health Medical Center, Denver, Colorado, USA.
authors.forename: Rodrigo Donalisi
authors.initials: RD
authors.lastname: da Silva
authors.forename: Paulo
authors.initials: P
authors.lastname: Jaworski
authors.forename: Diedra
authors.initials: D
authors.lastname: Gustafson
authors.forename: Leticia
authors.initials: L
authors.lastname: Nogueira
authors.forename: Francis
authors.initials: F
authors.lastname: Kang
authors.forename: Wilson
authors.initials: W
authors.lastname: Molina
authors.forename: Fernando J
authors.initials: FJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D003452:Cryosurgery / Q000379:methods*; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D059351:Organ Sparing Treatments / Q000379:methods; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome