Cryoablation of Renal Angiomyolipoma: An Evaluation of Safety and Efficacy

• Published in: Journal of endourology Vol. 31; no. 11; p. 1117
• Main Authors: Makki, Ahmad, Graumann, Ole, Høyer, Søren, Solvig, Jan, Østraat, Øyvind, Madsen, Mia Gebauer, Nielsen, Tommy Kjærgaard
• Format: Journal Article
• Language: English
• Published: United States 01.11.2017
• Subjects: Adult; Angiomyolipoma - diagnostic imaging; Angiomyolipoma - surgery; Cryosurgery - standards; Denmark; Female; Humans; Kidney Neoplasms - diagnostic imaging; Kidney Neoplasms - surgery; Laparoscopy; Male; Middle Aged; Neoplasm Recurrence, Local - diagnostic imaging; Neoplasm Recurrence, Local - surgery; Patient Safety; Postoperative Complications; Retrospective Studies; renal angiomyolipoma; laparoscopic cryoablation; percutaneous cryoablation; safety; efficacy
• ISSN: 1557-900X
• DOI: 10.1089/end.2017.0376

Small series have reported that cryoablation (CA) is a safe and feasible minimally invasive nephron-sparing alternative for the treatment of renal angiomyolipomas (renal AMLs). The aim of the present study was to investigate the safety and efficacy of CA in patients with renal AML. A retrospective review of 19 renal AML lesions treated with CA at Aarhus University Hospital, Denmark, over a 5-year period. The treatment was performed as laparoscopy-assisted CA on 7 lesions, and in the remaining 12 lesions CA was performed as a percutaneous ultrasound-guided CA. The mean patient age was 46 years [interquartile range (IQR) 30] and the mean tumor volume was 50.1 cm (IQR 53.3). In all cases, the procedure was effectively conducted with no conversion to open surgery, and no major complications were experienced. The mean follow-up time was 25 months (IQR 13). Mean maximum tumor volume was reduced from 50.1 cm (IQR 53.3) to 12.2 cm (IQR 14.1), p = 0.05. No patients presented with retroperitoneal hemorrhage or recurrence during follow-up. Treating renal AMLs with CA appears to be a safe and effective nephron-sparing approach and could be a valuable alternative to other treatment modalities. The low complication rate, absence of retreatment and a good preservation of renal function might allow treatment of even subclinical renal AMLs to minimize the risk of potentially life-threatening hemorrhage.