CRYOABLATION THERAPY (CAT) FOR ADENOCARCINOMA OF THE KIDNEY. 1995 UP TO DATE AND CASE REPORT.
September 1996
F. Lugnani (Contact address: fmlugnani@interware.it), P. de Morpurgo.
Sanatorio Triestino, Trieste, Italy.
CAT has been recently introduced as an alternative means to treat prostatic cancer (PC).
Single authors are exploring a possible application of the procedure also in the treatment of kidney malignancies.
Possible advantages include effectiveness in treating also locally advanced cancers,
low morbidity especially in cases of patients in bad conditions, and a yet unexplored immunological effect.
We report the results observed in 1 patient treated with CAT for a renal solid mass.
An 82 years old slim patient with a 2.5 solid tumor in the mid external margin of the left kidney was treated with CAT under general anesthesia using a percutaneous ultrasound guided approach.
The patient was prepared in the usual nephrectomy position over the operating bed.
Two 3 mm of diameter cryoprobes connected to an Accuprobe System were used to ensure adequate freezing of the tumor.
The system permits to reach fast cooling of tissues thanks to the circulation of supercooled liquid nitrogen ( -202°).
The most difficult part of the procedure has been the proper location of the cryoprobes because of the movements of the kidney related to the respiratory activity.
Only when the first probe was placed anchoring the kidney in a fixed location, we were able to insert securely the second one in the tumor.
At the end of the freezing procedure probes were removed with no drenage left in place.
The p.o. hematological parameters showed no alteration during the following days.
The patient left the hospital in perfect conditions after 3 days.
Three months later a CT scan was performed demonstrating an augmentation of density of the frozen area together with a diminished nephrogenic effect of the contrast medium.
Only a long follow-up of this and many other cases will allow to draw conclusions over this procedure.
With this intent the author is also presenting a revision of the literature and a report of anedoctical personal communications.
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