Abstract
IntroductionThermal destruction mediated by radiofrequency ablation (RFA) is gaining attention as an alternative treatment for patients with renal cell carcinoma (RCC), particularly in those who are not candidates for open surgery. Treatment of central tumours is occasionally associated with complications such as ureteric stricture, injury to the psoas muscle, haematuria and vascular laceration.Case presentationWe have used infusion of cold saline during RFA, through a retrograde ureteric catheter with its tip in the renal pelvis, in a patient with a central renal tumour.ConclusionWe believe this process to have successfully avoided the risk of thermal injury.
Highlights
Thermal destruction mediated by radiofrequency ablation (RFA) is gaining attention as an alternative treatment for patients with renal cell carcinoma (RCC), in those who are not candidates for open surgery [1]
We have used infusion of cold saline during RFA, through a retrograde ureteric catheter with its tip in the renal pelvis, in a patient with a central renal tumour in order to reduce the risk of thermal injury
Partial nephrectomy is the standard therapy for small RCC [2], minimally invasive options associated with limited morbidity–such as probe-ablative procedures–are, being investigated in selected patients for whom invasive, nephron
Summary
Thermal destruction mediated by radiofrequency ablation (RFA) is gaining attention as an alternative treatment for patients with renal cell carcinoma (RCC), in those who are not candidates for open surgery [1]. We have used infusion of cold saline during RFA, through a retrograde ureteric catheter with its tip in the renal pelvis, in a patient with a central renal tumour in order to reduce the risk of thermal injury. CgcFeiogsnnttuirtvraeeal sop1toferpntrihiomannacaredydjRacCCeTCntsmctoaenathssuehrorinwegnsa3al.2prie×glhv3its.2k(ibd×lna3ec.ky8macrmarsoswsi)uthg-a Contrast enhanced CT scan shows a right kidney mass suggestive of primary RCC measuring 3.2 × 3.2 × 3.8 cm with a central portion adjacent to the renal pelvis (black arrow). Prior to the RFA procedure, a 4.8 F retrograde ureteric catheter was inserted under endoscopic guidance and its tip advanced to the right renal pelvis (Fig 2). A Foley 14 F urethral catheter was inserted in the bladder and attached to a drainage bag This system was used to irrigate the renal pelvis with cold saline (0.9%) at a rate of 1 l/hour. Up CT at six months shows no evidence of recurrent tumour or hydronephrosis
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