Renal cryoablation has become accepted as treatment for small renal tumors as an alternative to surgery. However, parallel with the increase in the use of this therapy, there also has been increases in the number of reports of complications related to renal cryoablation. One potential complication is injury to important non-renal structures adjacent to the ablated renal tumor, such as the colon, duodenum, ureter, psoas muscle and so on. To prevent injury of adjacent organs, separating organs from the tumor is desirable. Over the past 15 years, several techniques have been developed to protect against injury of organs adjacent to renal tumors that are targets of cryoablation. The most commonly used technique for this purpose has been hydrodissection. Others include dissection with gas, balloon dissection and probe traction. To avoid injury of a ureter running near the renal tumor, pyeloperfusion is known to be useful. The rate of cases necessitating avoidance of organ injury by using these techniques is relatively high. In some cases, more than two techniques are combined. In the present review, we provided an overview of techniques currently available to protect against organ injuries, and discussed the advantages and disadvantages of each technique.
International journal of urology : official journal of the Japanese Urological Association. 2019 May 15 [Epub ahead of print]
Takuji Yamagami, Rika Yoshimatsu, Kenji Kajiwara, Tomoaki Yamanishi, Hiroki Minamiguchi, Takashi Karashima, Keiji Inoue
Department of Radiology, Kochi Medical School, Kochi University, Nankoku, Kochi, Japan., Department of Urology, Kochi Medical School, Kochi University, Nankoku, Kochi, Japan.