Non-Ischemic Enucleation of Small Renal Cell Carcinoma using Microwave Tissue Coagulator

Abstract

Non-ischemic enucleation of small renal cell carcinoma using microwave tissue coagulator was performed on 13 kidneys of 12 patients (average 64.2 years old) at Nara Medical University Hospital and its affiliated hospitals between September 1993 and June 1995. The indication for nephron-sparing surgery were elective in 8 cases and imperative in 5 kidneys of 4 cases. The renal cell carcinoma size was on average 36.8 mm (20-50 mm). The demarcation line, 7 - 10 mm apart from the tumor margin, was defined under ultrasonography, and was coagulated at every 8 - 10 mm interval along the demarcation line with the microwave monopolar antenna needle. The renal tumor was excised along the middle of coagulated zone with scissors and blunt dissection. The operation time was on average 174.2 minutes, and perioperative bleeding was average 249.5 ml, excluding case 2 who underwent partial hepatectomy for metastatic rectal cancer simultaneously. No major complication was encountered. Local recurrence and severe impairment of the remaining kidney were not observed in all cases at the median 9.6 months of follow-up. In situ non-ischemic tumor enucleation using microwave tissue coagulator constitutes a simple, reliable, and less invasive alternative to ordinary nephron-sparing surgery, and is indicated for small asymptomatic renal cell carcinoma.