Rad-10. Interventional MRI directed and monitored percutaneous cryoablation of renal tumors.Three-year data are presented defining the success and complications with regard to this ongoing study. Patients entered into this study had renal tumors as identified on diagnostic Computer Tomographic Interventional Magnetic Imaging. Patients who could benefit from nephron nephron: see urinary system. nephron Functional unit of the kidney that removes waste and excess substances from the blood to produce urine. Each of the million or so nephrons in each kidney is a tubule 1.2–2.2 in. (30–55 mm) long. sparing surgery were offered this procedure. Candidates included those patients with solitary kidneys, bilateral tumors, and patients with co-morbidity preventing traditional surgical resection. To date, 64 patients with 72 tumors have been treated. Patient demographics include 49 males, 15 females, and a mean age of 64 years. Seventeen patients had solitary kidneys. The mean tumor size was 2.6 cm (1.0-7.0). Successful treatment was achieved in 91%. A 9% treatment failure rate was seen with renal tumors abutting the renal hilum hilum /hi·lum/ (hi´lum) pl. hi´la [L.] a depression or pit on an organ, giving entrance and exit to vessels and nerves.hi´lar hi·lum n. pl. or collecting system, as well as large tumors (> 5 cm in diameter or having a large heat sink effect). Re-treatment was needed in 14% of patients as their post-cryo imaging studies demonstrated tissue suspicious for residual tumor. Two patients are alive with residual tumor. Five patients have died of non-renal tumor disease giving a 92% overall survival with a mean 22-month (2-36) follow-up. There is a 100% disease specific survival at a mean 22-month (2-36) follow-up. Complications encountered include one peri-nephritic hemorrhage, one superficial wound abscess abscess, localized inflamation associated with tissue necrosis. Abscesses are characterized by inflamation, which is due to the accumulation of pus in the local tissues, and often painful swelling. , two urinary tract infections, and six episodes of post-op gross hematuria hematuria Blood in the urine. It usually indicates injury or disease of the kidney or another structure of the urinary system or possibly, in males, the reproductive system. It may result from infection, inflammation, tumours, kidney stones, or other disorders. . All complications resolved without sequela sequela /se·que·la/ (se-kwel´ah) pl. seque´lae [L.] a morbid condition following or occurring as a consequence of another condition or event. se·quel·a n. pl. ; 3-year results demonstrate minimal procedural morbidity with excellent disease specific survival. Analysis of treatment success/failure rates confirm that large tumor size, or tumor abutting the renal vessels or collecting system, is associated with residual tumor and thus are poor candidates for this procedure as it currently exists. This limitation might be overcome with pre-cryo tumor embolization embolization /em·bo·li·za·tion/ (em?bo-li-za´shun) 1. the process or condition of becoming an embolus. 2. therapeutic introduction of a substance into a vessel in order to occlude it. . Long-term follow-up will further define treatment success/failure rates. Patrick E. Sewell, Jr, MD, and W. Bruce Shingleton, MD. University of Mississippi The University of Mississippi, also known as Ole Miss, is a public, coeducational research university located in Oxford, Mississippi. Founded in 1848, the school is composed of the main campus in Oxford and three branch campuses located in Booneville, Tupelo, and Southaven. Medical School, Department of Radiology and Division of Urology, Jackson MI. |
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