Use of Radiofrequency in Robot-Assisted Partial Nephrectomy for Small Tumors: A Novel Technique
Introduction and Objectives: Radiofrequency is standardized for ablating small renal tumors, but evidence regarding its effects remains limited. Partial nephrectomy, the gold standard, often leads to hemorrhagic complications and irreversible renal damage due to hilum clamping. To mitigate these ris...
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MDPI AG
2025-04-01
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| Series: | Current Oncology |
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| Online Access: | https://www.mdpi.com/1718-7729/32/5/246 |
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| author | Matías Larrañaga Helga Ibañez Jessica Pfeifer Cristobal Román Rubén Olivares José Antonio Salvadó José Miguel Cabello Sergio Moreno Renato Cabello Carmen Franco Alfredo Velasco |
| author_facet | Matías Larrañaga Helga Ibañez Jessica Pfeifer Cristobal Román Rubén Olivares José Antonio Salvadó José Miguel Cabello Sergio Moreno Renato Cabello Carmen Franco Alfredo Velasco |
| author_sort | Matías Larrañaga |
| collection | DOAJ |
| description | Introduction and Objectives: Radiofrequency is standardized for ablating small renal tumors, but evidence regarding its effects remains limited. Partial nephrectomy, the gold standard, often leads to hemorrhagic complications and irreversible renal damage due to hilum clamping. To mitigate these risks, we propose a novel technique that replaces clamping with radiofrequency ablation of the tumor for hemostasis in robot-assisted partial nephrectomy. Methods: We report on 357 consecutive patients with T1a renal tumors treated with robot-assisted surgery between 2010 and July 2024. Radiofrequency was used peri-tumorally for hemostasis, followed by complete lesion enucleation. Follow-up included ultrasound and creatinine at 1 month, CT scans at months 3 and 9, and then annually for 5 years. Results: The median age was 60.2 years, with 251 men (70.3%). The median tumor size was 22 mm, and the median blood loss was 15 mL. Hemorrhagic complications occurred in eight patients (2.2%), with one requiring a blood transfusion (0.28%). A total of 30 patients experienced transient stage 1 acute kidney disease (8.4%), with no significant change in median 74.92 mL/min/1.77 m<sup>2</sup> vs. 78.77 mL/min/1.77 m<sup>2</sup> vs. (<i>p</i>-value 0.15). The median follow-up was 48.2 months, with no tumor recurrence at the treated site. Renal cell carcinoma was found in 83.7% of tumors. Conclusions: To our knowledge, this series represent the largest global undertaking of renal tumor treatment using peripheral radiofrequency ablation without clamping, demonstrating optimal surgical and oncological outcomes, lower morbidity, and fewer complications compared to those noted in the revised literature regarding traditional clamping techniques. |
| format | Article |
| id | doaj-art-e3a9c68597df47c2b5c3ee07601a1361 |
| institution | DOAJ |
| issn | 1198-0052 1718-7729 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj-art-e3a9c68597df47c2b5c3ee07601a13612025-08-20T03:14:39ZengMDPI AGCurrent Oncology1198-00521718-77292025-04-0132524610.3390/curroncol32050246Use of Radiofrequency in Robot-Assisted Partial Nephrectomy for Small Tumors: A Novel TechniqueMatías Larrañaga0Helga Ibañez1Jessica Pfeifer2Cristobal Román3Rubén Olivares4José Antonio Salvadó5José Miguel Cabello6Sergio Moreno7Renato Cabello8Carmen Franco9Alfredo Velasco10Urology Intern Program, Faculty of Medicine, Finis Terrae University, Santiago 7501014, ChileUrology Resident Program, Faculty of Medicine, Finis Terrae University, Santiago 7501014, ChileDepartment of Urology, Santa María Clinic, Santiago 7520378, ChileDepartment of Urology, Santa María Clinic, Santiago 7520378, ChileDepartment of Urology, Cleveland Clinic, Cleveland, OH 44195, USADepartment of Urology, Santa María Clinic, Santiago 7520378, ChileDepartment of Urology, Santa María Clinic, Santiago 7520378, ChileDepartment of Urology, Santa María Clinic, Santiago 7520378, ChileDepartment of Urology, Santa María Clinic, Santiago 7520378, ChileDepartment of Pathology, Santa María Clinic, Santiago 7520378, ChileDepartment of Urology, Santa María Clinic, Santiago 7520378, ChileIntroduction and Objectives: Radiofrequency is standardized for ablating small renal tumors, but evidence regarding its effects remains limited. Partial nephrectomy, the gold standard, often leads to hemorrhagic complications and irreversible renal damage due to hilum clamping. To mitigate these risks, we propose a novel technique that replaces clamping with radiofrequency ablation of the tumor for hemostasis in robot-assisted partial nephrectomy. Methods: We report on 357 consecutive patients with T1a renal tumors treated with robot-assisted surgery between 2010 and July 2024. Radiofrequency was used peri-tumorally for hemostasis, followed by complete lesion enucleation. Follow-up included ultrasound and creatinine at 1 month, CT scans at months 3 and 9, and then annually for 5 years. Results: The median age was 60.2 years, with 251 men (70.3%). The median tumor size was 22 mm, and the median blood loss was 15 mL. Hemorrhagic complications occurred in eight patients (2.2%), with one requiring a blood transfusion (0.28%). A total of 30 patients experienced transient stage 1 acute kidney disease (8.4%), with no significant change in median 74.92 mL/min/1.77 m<sup>2</sup> vs. 78.77 mL/min/1.77 m<sup>2</sup> vs. (<i>p</i>-value 0.15). The median follow-up was 48.2 months, with no tumor recurrence at the treated site. Renal cell carcinoma was found in 83.7% of tumors. Conclusions: To our knowledge, this series represent the largest global undertaking of renal tumor treatment using peripheral radiofrequency ablation without clamping, demonstrating optimal surgical and oncological outcomes, lower morbidity, and fewer complications compared to those noted in the revised literature regarding traditional clamping techniques.https://www.mdpi.com/1718-7729/32/5/246partial nephrectomyradiofrequency ablationtumorectomynovel techniquenephron-sparing |
| spellingShingle | Matías Larrañaga Helga Ibañez Jessica Pfeifer Cristobal Román Rubén Olivares José Antonio Salvadó José Miguel Cabello Sergio Moreno Renato Cabello Carmen Franco Alfredo Velasco Use of Radiofrequency in Robot-Assisted Partial Nephrectomy for Small Tumors: A Novel Technique Current Oncology partial nephrectomy radiofrequency ablation tumorectomy novel technique nephron-sparing |
| title | Use of Radiofrequency in Robot-Assisted Partial Nephrectomy for Small Tumors: A Novel Technique |
| title_full | Use of Radiofrequency in Robot-Assisted Partial Nephrectomy for Small Tumors: A Novel Technique |
| title_fullStr | Use of Radiofrequency in Robot-Assisted Partial Nephrectomy for Small Tumors: A Novel Technique |
| title_full_unstemmed | Use of Radiofrequency in Robot-Assisted Partial Nephrectomy for Small Tumors: A Novel Technique |
| title_short | Use of Radiofrequency in Robot-Assisted Partial Nephrectomy for Small Tumors: A Novel Technique |
| title_sort | use of radiofrequency in robot assisted partial nephrectomy for small tumors a novel technique |
| topic | partial nephrectomy radiofrequency ablation tumorectomy novel technique nephron-sparing |
| url | https://www.mdpi.com/1718-7729/32/5/246 |
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