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Dr. Best, the presenting author, noted that morbidity and recovery time for this procedure are short, but despite this most patients are hospitalized overnight for observation.
They analyzed two outcomes: 1) bleeding complications, and 2) patients who were identified retrospectively as ones to have benefited from hospitalization. Overall, they found that these two factors were rare. Only 2.5% had bleeding complications, and only 6% of patients were judged retrospectively to have benefited from hospitalization.
Specifically, they reported that patients with a BMI of 39, and those with tumors close to 4 cm, and complex tumors with a RENAL nephrometry score of 9 had greater risks of bleeding complications. Importantly, they noted that the use of 3 or more ablation probes resulted in about a 19-fold increased risk of bleeding. Additionally, they noted that patients with tumors at least 3 cm in size, a RENAL nephrometry score greater than 8, the use of at least 3 probes, and post-operative hematoma on CT all resulted in a beneficial admission for the patient.
Dr. Best stated that these results have changed the admission practices at UW – Madison, and they are now only admitting patients with tumors greater than 3 cm, if 3 or more probes were used, or if they see a hematoma on the post-operative CT scan.
Sara L. Best¹, E. Jason Abel¹, J. Louis Hinshaw², Saira Khanna¹, Marki Klapperich², Fred Lee², Meghan Lubner², Shane Wells², Tyler Wittman¹, Timothy Ziemlewicz², Stephen Y. Nakada¹
¹University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA, Department of Urology
²University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA, Department of Radiology
Written By: Shoaib Safiullah, MS4 at The Chicago Medical School, LIFT Urology research fellow
34th World Congress of Endourology and SAUA meeting - November 7-12, 2016 – Cape Town, South Africa