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Artículo Tomo 70, Número. 5, Junio 2017

Archivos Españoles de Urología

Renal tumors percutaneous ablation by microwave. Initial experience.

Authors: Juan Sebastian Toro-Gutierrez, Juan Jose Espejo-Herrero, Maria Sagrario Lombardo-Galera, Maria Eugenia Pérez-Montilla, Miguel Canis-López, Luis Zurera-Tendero y Juan Manuel Rubio.

Arch. Esp. Urol. 2017; 70 (5): 525-533

Vol. 70, Number. 5, June 2017

OBJECTIVE: To analyze retrospectively the safety and effectiveness of percutaneous microwave ablation of solid renal tumors, and also review different approach techniques.

METHODS: It is a retrospective study approved by the ethics committee of both hospitals. 14 tumors with a mean size of 37 mm (12-50 mm) were treated in a single session, under general anesthesia and with CT guidance, in 14 patients (9 men) with a mean age of 66 years, using the ablation system AMICA by different approaches (trans pulmonary, trans peritoneal and retroperitoneal). A biopsy was performed with a core needle to 13 of them prior to ablation in the same session. CT abdominal follow-up was performed (with and without i.v. contrast) at 1, 3, 6, 12, 18 and 24 months after ablation. Changes in serum creatinine levels pre- and post-ablation were also analyzed.

RESULTS: The average follow-up time was 16.5 months (3-28 months) and we obtained complete response in 100% of the treated tumors. Only two minor complications were observed: one self-limited perirenal hemorrhage and one asymptomatic hydronephrosis, in the two patients to whom we did a transpulmonary approach, without pneumothorax in any of them.

CONCLUSION: Percutaneous ablation of renal tumors seems to be a safe and effective technique, either via transpulmonary, transperitoneal or retroperitoneal approach, depending on tumor location.

KEY POINTS: • Microwave ablation produces coagulation necrosis. • The sink effect is smaller in microwave ablation. • Microwave ablation seems to be safe and effective. • The type of approach is not correlated with major complications (Clavien> o =II).

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