WCE 2016: Preoperative and Operative Variables Predict Which Patients Can Be Discharged Without Admission After Percutaneous Ablation of RCC - Session Highlights

Cape Town, South Africa (UroToday.com) In hopes of identifying patients needing hospitalization following percutaneous thermoablation for small renal cell carcinoma, researchers at the University of Wisconsin – Madison conducted a study to elucidate characteristics that may predict complications occurring in the early post-operative period.

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.

Presented by:
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