WCE 2017: Kidney irreversible electroporation does not cause significant injury to adjacent ureter or bowel in a porcine model

Vancouver, Canada (UroToday.com) Sorokin et al. evaluated the potential for irreversible electroporation (IRE) to cause ureteral or bowel injury in a porcine kidney model. Six adults pigs underwent bilateral IRE for a total of twelve renal units. IRE of the left anterior lower pole was used to target the left proximal ureter, which was tacked in between two monopolar probes. A similar setup was used on the right side to target the small bowel. IRE was delivered at 2000 V/cm for 70 pulses followed by another 70 pulses in reverse polarity.

On histopathology, inflammatory changes present in the early post-IRE period resolved by day fourteen with no residual damage to the mucosal or muscularis layers of the ureter or bowel.

The effort of the authors to explore the safety of IRE for renal masses adjacent to the ureter and/or bowel deserves praise. However, the relevance of these results is questionable, given that this group recently reported inferior 2-year local recurrence-free survival for IRE in patients with cT1a renal masses when compared to radiofrequency ablation and cryoablation. Therefore, the more important question is what role, if any, does IRE have in the management of small renal masses.

Authors: Igor Sorokin, Noah Canvasser, Elena Lucas, Brett A. Johnson, Jeffrey Cadeddu – University of Texas Southwestern, Dallas, TX, USA

Written by: Michael Owyong (@ohyoungmike), LIFT Fellow, Department of Urology, UC Irvine Medical Center, Orange, CA, USA at the 35th World Congress of Endourology– September 12-16, 2017, Vancouver, Canada.

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