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Abstract

We thank the author for his kind and insightful comments and for highlighting the key literature comparing cryoablation with partial nephrectomy of small renal masses. As previously stated, a recent meta-analysis found that the oncologic outcomes for cryoablation are significantly worse than partial nephrectomy, a finding that was consistent in our study. 1 Klatte T. Shariat S.F. Remzi M. Systematic Review and meta-analysis of perioperative and oncologic outcomes of laparoscopic cryoablation versus laparoscopic partial nephrectomy for the treatment of small renal tumors. J Urol. 2013; Google Scholar We recognize that, as our experience with ablative techniques increases, this gap in oncologic control may narrow as highlighted by the UK study. 2 Breen D.J. Bryant T.J. Appas A. et al. Percutaneous cryoablation of renal tumours: outcomes from 171 tumours in 147 patients. BJU Int. 2013; 112: 758-765 Crossref PubMed Scopus (85) Google Scholar The author correctly points out that we have not performed laparoscopic cryoablation since 2009, instead preferring a percutaneous approach particularly because it does not require a general anesthetic and is less invasive. We have not yet performed percutaneous cryoablation as an outpatient procedure but appreciate that, in an era that emphasizes efficiency and cost savings, this is another potential advantage of a percutaneous approach. Editorial CommentUrologyVol. 83Issue 5PreviewSmall renal masses <4 cm in patients with significant medical comorbidities remain a management dilemma for urologic surgeons. Although surgical extirpation remains the gold standard for management of renal cell carcinoma, cryoablative technology may be a reasonable alternative for poor surgical candidates. The present study reports the outcomes of 263 patients who underwent either laparoscopic (LCA) or percutaneous cryoablation (PCA) of T1a renal tumors. Both approaches of tumor ablation were well tolerated with minimal morbidity. Full-Text PDF