Cryotherapy of Kidney Tumours
What is cryoablation?
The cryoablation or freezing of kidney tumours is a minimally invasive approach in the treatment of small renal masses i.e kidney cancer tumours less than 4cm in maximum size.
The concept of cryoablation is based upon the principles that lead to frost bite; the freezing temperature created (< - 40oC) by the passage of high pressure argon, causes localised cell death both by freezing of the cells themselves, but equally as importantly, by destroying the blood supply to those cells.
Laparoscopic assisted or percutaneous image guided cryoablation
A laparoscopic/ key-hole surgery guided approach or a percutaneous approach in the CT scanner allow very accurate placement of the specially designed ‘ice sphere’ needles through the skin and directly into the tumour.
Performing this treatment at laparoscopic or key-hole surgery allows cryo-needle placement not only under direct vision, but also, using special ultrasound equipment to confirm the position of the needles, it also means that the extent of the ice ball that is formed during the process itself can be monitored, which in tandem with the use of temperature measuring needles, means three ways of ensuring accurate and complete treatment. However, whilst still involving a prolonged general anaesthetic, the percutaneous approach in the CT scanner means accurate placement of the needles with visualisation of the ‘ice ball’ by CT imaging during treatment to ensure accuracy, but without the need of any surgical wound, however small.
The attraction of this procedure relates to the huge reduction in the required surgical dissection in application of the kidney cancer treatment compared to the partial nephrectomy, where the tumour is cut out. As a result, the associated risks of this procedure must be significantly reduced in comparison and relate mainly to bleeding at the time of withdrawal of the cryo-needles themselves. With modern technology this is very rarely a problem.
In essence this means that the freezing or cryoablation of small kidney cancer tumours is safe, even in those with other medical problems and is associated with an extremely rapid discharge from hospital and return to normal activity. This is true whether a laparoscopic/ key-hole or percutaneous, CT guided approach is used. These procedures, in fact, may even be performed as a day case.
The weight of evidence is such that laparoscopic guided and percutaneous treatment now has approval by NICE (National Institute for Clinical Excellence).
Further information on the cryoablation procedure for the treatment of kidney cancer can be found at: http://www.galilmedical.com/treatments/kidney-cancer/