Haemostatic Radiofrequency Ablation Assisted Partial Nephrectomy: Is Radiofrequency Energy a Viable Solution?

Aim: We present our experience with partial nephrectomy using radiofrequency energy in patients with kidney cancer. Methods: From July 2002 to February 2007, 15 radiofrequency ablation assisted partial nephrectomies were performed. Five patients had one kidney only. The average tumour size was 34 (range 22–55) mm, and the mean age was 56 (range 45–69) years. The renal pedicle was not clamped. A monopolar cool-tip radiofrequency device under intra-operative ultrasound guidance was used. Our procedure involved inserting a radiofrequency probe around the tumour. The average ablation time was 6–12 min. Afterwards the tumour was removed and analyzed histopathologically. Results: The average follow-up period was 15 (range 1–42) months. Eleven procedures were performed without any complications. In 4 cases, delayed urine leakage was observed. Histopathological examination revealed 13 clear cell renal cell carcinomas and 2 oncocytomas. In all cases the coagulated surgical margins were negative. Currently, the surviving patients have a well-preserved renal function, and there was no tumour recurrence. Conclusions: Radiofrequency ablation assisted partial nephrectomy seems to be an effective method of nephron-sparing surgery. The major advantages of this procedure include easy tumour extraction and no signs of bleeding.