RESUMEN
INTRODUCTION: Standard treatment for small renal masses is partial nephrectomy, which has shown oncological results similar to radical nephrectomy. Ablation procedures such as radiofrequency and cryotherapy have recently been developed in order to minimize the side effects of conventional surgical excision. This article reviews radiofrequency ablation. MATERIALS AND METHODS: For this review, a search was made in the Medline database using the term "renal radiofrequency ablation". RESULTS: The different currently marketed systems for delivery of radiofrequency energy are examined. The different delivery approaches (open, laparoscopic, and percutaneous) are described. A trend towards use of the percutaneous approach was seen. Published clinical studies already include patient series with mid-term follow-ups (3 years) showing oncological outcomes similar to conventional resection procedures with fewer complications. CONCLUSIONS: Renal tumor radiofrequency ablation has proved to be an effective treatment with minimal complications. However, it should only be used in selected patients until longer follow-up studies are available.
Asunto(s)
Carcinoma de Células Renales/cirugía , Ablación por Catéter , Neoplasias Renales/cirugía , Animales , Ablación por Catéter/métodos , HumanosRESUMEN
INTRODUCTION: The standard treatment of small renal masses is partial nephrectomy, which has showed similar oncologic results when compared with radical nephrectomy. Recently, ablative techniques, including radiofrequency and cryotherapy ablation, has been developed, with the purpose of minimizing adverse effects of standard surgical excision. In this article we review the technique of radiofrequency ablation. MATERIAL AND METHODS: For this review we conducted a search in the Medline database using the terms "renal radiofrequency ablation". RESULTS: The different currently marketed systems for the delivery of radiofrequency energy are examined. The different techniques of delivery (open, laparoscopic and percutaneous) are described; we observe a trend towards the use of the percutaneous method. Among the published clinical studies there are series of patients with midterm follow-up (3 years) that show oncologic outcomes similar to traditional resection techniques, with fewer complications. CONCLUSIONS: Renal tumor radiofrequency ablation has proved an effective therapy with minimal complications. However, it should be used only in selected patients until longer follow-up studies are available.
Asunto(s)
Carcinoma de Células Renales/cirugía , Ablación por Catéter , Neoplasias Renales/cirugía , Ensayos Clínicos como Asunto , HumanosRESUMEN
Introducción: El tratamiento estándar de las masas renales de pequeño tamaño es la nefrectomía parcial, que ha demostrado unos resultados oncológicos semejantes a la nefrectomía radical. Recientemente se han desarrollado técnicas de ablación como la radiofrecuencia y la crioterapia, con el fin de minimizar los efectos secundarios de la resección quirúrgica convencional. En este artículo, revisamos la técnica de ablación mediante radiofrecuencia. Material y métodos: Para esta revisión se ha utilizado la base de datos Medline introduciendo los términos renal radiofrequencyablation. Resultados: Se analizan los diferentes sistemas que existen en el mercado para la aplicación de radiofrecuencia. Se describen las técnicas de aplicación (abierta, laparoscópica y percutánea), observando una tendencia clara a la aplicación de forma percutánea. En los estudios clínicos publicados existen ya series de pacientes con seguimientos a medio plazo (3 años) en los que se demuestra unos resultados oncológicos semejantes a los de las técnicas de resección clásicas y con un índice de complicaciones menor. Conclusiones: La ablación de tumores renales con radiofrecuencia ha demostrado ser un tratamiento eficaz y con mínimas complicaciones. Sin embargo, hasta que no existan seguimientos a largo plazo, se debe utilizar únicamente en pacientes seleccionados (AU)
Introduction: Standard treatment for small renal masses is partial nephrectomy, which has shown oncological results similar to radical nephrectomy. Ablation procedures such as radiofrequency and cryotherapy have recently been developed in order to minimize the side effects of conventional surgical excision. This article reviews radiofrequency ablation. Materials and methods: For this review, a search was made in the Medline database using the term renal radiofrequency ablation. Results: The different currently marketed systems for delivery of radiofrequency energy are examined. The different delivery approaches (open, laparoscopic, and percutaneous) are described. A trend towards use of the percutaneous approach was seen. Published clinical studies already include patient series with mid-term follow-ups (3 years) showing oncological outcomes similar to conventional resection procedures with fewer complications. Conclusions: Renal tumor radiofrequency ablation has proved to be an effective treatment with minimal complications. However, it should only be used in selected patients until longer follow-up studies are available (AU)
Asunto(s)
Humanos , Masculino , Femenino , Neoplasias Renales/cirugía , Ablación por Catéter/métodos , Carcinoma de Células Renales/cirugía , Nefrectomía , Crioterapia/métodos , Electrodos , LaparoscopíaRESUMEN
Introducción: El tratamiento estándar de las masas renales de pequeño tamaño es la nefrectomía parcial, que ha demostrado unos resultados oncológicos semejantes a la nefrectomía radical. Recientemente se han desarrollado técnicas de ablación como la radiofrecuencia y la crioterapia, con el fin de minimizar los efectos secundarios de la resección quirúrgica convencional. En este artículo, revisamos la técnica de ablación mediante radiofrecuencia. Material y Métodos: Para esta revisión se ha utilizado la base de datos Medline introduciendo los términos renal radiofrequency ablation. Resultados: Se analizan los diferentes sistemas que existen en el mercado para la aplicación de radiofrecuencia. Se describen las técnicas de aplicación (abierta, laparoscópica y percutánea), observando una tendencia clara a la aplicación de forma percutánea. En los estudios clínicos publicados existen ya series de pacientes con seguimientos a medio plazo (3 años) en los que se demuestra unos resultados oncológicos semejantes a los de las técnicas de resección clásicas y con un índice de complicaciones menor. Conclusiones: La ablación de tumores renales con radiofrecuencia ha demostrado ser un tratamiento eficaz y con mínimas complicaciones. Sin embargo, hasta que no existan seguimientos a largo plazo, se debe utilizar únicamente en pacientes seleccionados (AU)
Introduction: The standard treatment of small renal masses is partial nephrectomy, which has showed similar oncologic results when compared with radical nephrectomy. Recently, ablative techniques, including radiofrequency and cryotherapy ablation, has been developed, with the purpose of minimizing adverse effects of standard surgical excision. In this article we review the technique of radiofrequency ablation. Material and methods: For this review we conducted a search in the Medline database using the terms renal radiofrequency ablation. Results: The different currently marketed systems for the delivery of radiofrequency energy are examined. The different techniques of delivery (open, laparoscopic and percutaneous) are described; we observe a trend towards the use of the percutaneous method. Among the published clinical studies there are series of patients with midterm follow-up (3 years) that show oncologic outcomes similar to traditional resection techniques, with fewer complications. Conclusions: Renal tumor radiofrequency ablation has proved an effective therapy with minimal complications. However, it should be used only in selected patients until longer follow-up studies are available (AU)