KIDNEY CRYOABLATION
CLINICAL DATA

a. Patient Benefits

Minimally Invasive
An advantage of kidney cryoablation is that the procedure can be conducted percutaneously (directly through the skin), thus making it a minimally invasive procedure. The minimally invasive nature of the procedure means that it can be performed with minimal blood loss and without a large incision. A minimally invasive procedure, compared to an open surgical procedure, can mean significantly less pain, a shorter hospital stay, and more rapid recovery. As a minimally invasive procedure, cryoablation allows kidney cancer to be treated with much less disruption of patients’ lives. Patients usually are able to return to family, work, and routine activity in less than half the time that it takes to recover from an open surgical procedure.

Shorter Procedure with Fewer Complications
Patients who undergo cryoablation have less risk of experiencing some surgical complications, such as bleeding. The risk of excessive bleeding is decreased by not having to cut into the kidney as is typically done with a surgical procedure on the kidney, such as a partial or radical nephrectomy. Similarly, not cutting into the kidney minimizes the risk of disrupting the kidney’s collection system (the “plumbing” within the kidney which transports urine), which is a complication known as “urine leak.”

Preservation of Normal Kidney Tissue
Kidney cancer treatment that maintains adequate renal function is of the utmost importance to the patient’s ongoing quality of life. Because only the cancer is destroyed during cryoablation and normal kidney tissue is spared, remaining renal function is maximized. This means that the kidneys can continue to perform their many jobs more efficiently than if the entire kidney, or a significant part of it, had been removed.

In addition, sparing a portion of the affected kidney creates more options should a new tumor develop in the patient’s second kidney, a risk confronting a small number of people with kidney cancer.

Cryoablation is Repeatable
In most cases, image-guided targeted ablation and real time temperature monitoring assure that only one session of cryoablation is necessary. Should the patient’s cancer recur, or if residual tumor is found on follow-up visits, renal cryoablation can be repeated with minimal trauma to the patient.

b. Outcomes

Local Tumor Control
Local tumor control describes how well the cancer has been destroyed or limited in the target tissue. A high number means more effective control at the time of follow-up.

Numerous studies document cryoablation efficacy for local tumor control after a single treatment. Clinical evidence documents oncologic outcomes following cryoablation are comparable to the oncologic outcomes following partial nephrectomy.


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c. Complications

There are complications possible with any medical procedure and renal cryoablation is no exception. Complications that can occur during or after any procedure include problems related to general anesthesia and cardiovascular problems such as heart attack, stroke, deep vein thrombosis and pulmonary embolus. These problems rarely occur, and the risk depends on the patient’s general fitness for surgery and previous medical problems. Published data show that the location and size of the lesion can affect the risk for certain complications, as can the approach and technique employed to access the kidney. Overall, minimally invasive procedures have a lower complication rate than open surgeries.

Patients treated with cryoablation, compared to patients undergoing surgery, have less risk of bleeding because the physician is not actually cutting into the kidney. Similarly, not incising the kidney minimizes the risk of a complication known as “urine leak.” As used here, the term “urine leak” refers to urine leaking from the kidney’s internal collection system. This happens when the collection system is disrupted by the incision made into the kidney.

During the double freeze-thaw process of cryoablation, injury to nearby structures such as the blood vessels, spleen, liver, pancreas or bowel can occur. Great care is taken during every cryoablation procedure to avoid these injuries, and pre-procedure imaging studies aid the physician in planning the best approach, technique, and placement of the cryoablation needles to minimize trauma to healthy kidney tissue and adjacent structures.

Since patients undergoing cryoablation to destroy a kidney tumor report minimal pain, complications arising from the administration of pain killers are also kept to a minimum.

d. Follow-up Care

Recovery time and specific follow-up care will vary significantly depending on the approach, technique, and type of anesthesia used for the renal cancer ablation. However, there are some typical expectations.

After the procedure, the patient is taken to a recovery area, where vital signs and urinary output will be closely monitored. In most cases, many patients experience very little discomfort after an image-guided percutaneous procedure, but each case is treated on an individual basis with the goal of keeping the patient as comfortable as possible. Pain relief may be needed following an open or laparoscopic cryoablation procedure.

Patients remain in the hospital until they are eating, drinking, walking, and urinating satisfactorily. Again, depending on the approach, technique and anesthesia, this can vary from several hours, as in the case of an uneventful percutaneous kidney cryoablation, to a couple of days, in the case of cryoablation performed during an open surgical procedure. Should complications occur, it is possible that a longer hospital stay may be necessary.

There are several effective treatment protocols and standards of care that physicians follow for kidney cancer patients. CT or MRI scans will be repeated periodically to assess the effectiveness of the treatment.