title: [Laparoscopic radiofrequency ablation for centrally located renal tumors].
abstract: OBJECTIVE
  To study the safety and effectiveness of laparoscopic radiofrequency ablation for centrally located renal tumors.
  
  
  METHODS
  From January 2009 to April 2013, thirteen patients who diagnosed as centrally located renal tumors were treated with laparoscopic radiofrequency ablation in the Department of Urology of Nanjing Drum Tower Hospital Affiliated to Nanjing University Medical School. All of the cases were T1aN0M0 stage, 9 patients were male, 4 were female, the mean age was 56 years (range, 38-73 years). All tumors were unilateral, eight lesions were in the left kidney and five in the right kidney. Intraoperative real-time ultrasound and temperature probes were used to guide the range of radiofrequency ablation. Ice saline was injected through ureteral catheter for cooling the collecting system. The postoperative serum creatinine and glomerular filtration rate (GFR) data were collected,all patients were followed up with enhanced CT or MRI.The pre- and post-operative date were compared by paired t test.
  
  
  RESULTS
  All patients underwent laparoscopic radiofrequency ablation successfully. The mean operation time was (113±13) minutes and the mean blood loss was (99±23) ml. The mean pre- and post-operative serum creatinine was (71±11) µmol/L and (74±11) µmol/L, the mean pre- and post-operative GFR was (49±8) ml/min and (45±7) ml/min. There was no significant statistic difference between pre-operation and post-operation (t=-1.371 and 1.986, P>0.05). The mean follow-up was 37 months, range 12-63 months. No evidence of local recurrence or distant metastasis was found.
  
  
  CONCLUSIONS
  Laparoscopic radiofrequency ablation for T1aN0M0 centrally located renal tumors could be performed safely with good outcomes. Intraoperative real-time ultrasound and temperature probes are helpful to control the range of radiofrequency ablation. Physical cooling of renal collecting system could reduce the occurrence of postoperative hydronephrosis and leakage of urine.
authors.affiliation: Department of Urology, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, China.
authors.forename: Dongwei
authors.initials: D
authors.lastname: Yao
authors.affiliation: Email: qufeng01@gmail.com.
authors.forename: Feng
authors.initials: F
authors.lastname: Qu
authors.forename: Jinyu
authors.initials: J
authors.lastname: Zheng
authors.forename: Huibo
authors.initials: H
authors.lastname: Lian
authors.forename: Gutian
authors.initials: G
authors.lastname: Zhang
authors.forename: Xiaogong
authors.initials: X
authors.lastname: Li
authors.forename: Weidong
authors.initials: W
authors.lastname: Gan
authors.forename: Hongqian
authors.initials: H
authors.lastname: Guo
mesh_terms: D000328:Adult; D000368:Aged; D017115:Catheter Ablation; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney; D007680:Kidney Neoplasms / Q000628:therapy*; D010535:Laparoscopy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D061646:Operative Time; D011184:Postoperative Period; D016896:Treatment Outcome