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Radiofrequency ablation of renal tumors with an expandable multitined electrode: results, complications, and pilot evaluation of cooled pyeloperfusion for collecting system protection.
Rouvière O., Badet L., Murat F. J., Maréchal J. M., Colombel M., MARTIN X., Lyonnet D., Gelet A.
CardioVascular and Interventional Radiology 31, 3 (2008) 595-603 - http://hal.archives-ouvertes.fr/hal-00395714
Articles dans des revues avec comité de lecture
Sciences du Vivant/Ingénierie biomédicale
Radiofrequency ablation of renal tumors with an expandable multitined electrode: results, complications, and pilot evaluation of cooled pyeloperfusion for collecting system protection.
Olivier Rouvière 1, 2, Lionel Badet 3, François Joseph Murat 1, Jean Marie Maréchal 4, Marc Colombel 5, Xavier MARTIN 3, Denis Lyonnet 2, Albert Gelet 1, 2
1 :  Applications des ultrasons à la thérapie
http://www.lyon.inserm.fr/556/
INSERM : U556 – Université Claude Bernard - Lyon I
Centre de Recherche Inserm 151, Cours Albert Thomas 69424 LYON CEDEX 03
France
2 :  Hôpital Edouard Herriot
http://www.chu-lyon.fr/internet/chu/etablissements/heh/presentation_heh.htm
Hospices Civils de Lyon – Hôpital Edouard Herriot
5, place d'Arsonval - 69437 LYON cedex 03
France
3 :  Institut de biologie et chimie des protéines [Lyon] (IBCP)
http://www.ibcp.fr
CNRS : UMR5086 – Université Claude Bernard - Lyon I
7 Passage du Vercors 69367 LYON CEDEX 07
France
4 :  Laboratoire des Mécanismes et Transfert en Géologie (LMTG)
http://www.lmtg.obs-mip.fr/
CNRS : UMR5563 – Observatoire Midi-Pyrénées – Université Paul Sabatier [UPS] - Toulouse III – Institut de recherche pour le développement [IRD] : UMR154
14 avenue Edouard Belin 31400 Toulouse
France
5 :  Service d'urologie [Lyon]
http://www.chu-lyon.fr/web/2681
Hospices Civils de Lyon – Hôpital Pierre-Bénite
5, place d'Arsonval, 69437 Lyon cedex 03
France
The objective of this study was to retrospectively evaluate the results of radiofrequency ablation (RFA) of renal tumors with an impedance-based system using an expandable multitined electrode. Twenty-two patients (30 tumors) were treated with RFA over a 7-year period, percutaneously (16 tumors) or intraoperatively (14 tumors). Follow-up imaging was performed at 1-3, 6, and 12 months and yearly thereafter. Twenty-seven of 30 tumors (19/22 patients) showed no residual tumor on the first imaging control. Two residual tumors were successfully ablated by a second RFA procedure. Our mean follow-up period was 35 months (range, 3-84 months). Two tumors that had been completely ablated based on imaging criteria recurred 11 and 48 months after RFA. One was treated by partial nephrectomy. The other one was not treated because the patient developed bone metastases. One patient had nephrectomy because of an RFA-induced ureteropelvic junction stricture. Nine patients (11 sessions) had a pyeloperfusion of cooled saline during RFA. None developed symptomatic complications, even though in three patients the ablation zone extended to the closest calyx (3-5 mm from the tumor). We conclude that RFA of renal tumors is promising, but serious complications to the collecting system must be taken into consideration. Prophylactic per-procedural cooling of the collecting system is feasible but needs further assessment.
Anglais

CardioVascular and Interventional Radiology (Cardiovasc Intervent Radiol)
Publisher Springer Verlag (Germany)
ISSN 0174-1551 (eISSN : 1432-086X)
internationale
2008
05/02/2008
31
3
595-603

Adult – Aged – Carcinoma – Renal Cell – Catheter Ablation – Electrodes – Equipment Design – Female – Follow-Up Studies – Glomerular Filtration Rate – Humans – Hypothermia – Induced – Intraoperative Complications – Kidney Neoplasms – Kidney Pelvis – Male – Middle Aged – Multivariate Analysis – Neoplasm Staging – Perfusion – Pilot Projects – Probability – Retrospective Studies – Risk Assessment – Survival Analysis – Treatment Outcome