Laparoscopic and percutaneous radiofrequency ablation of the kidney: Acuteand chronic porcine study

Objectives. The chronic effects of renal radiofrequency ablation are unknow n. Herein, we investigate the anatomic and physiologic sequelae of laparosc opic and percutaneous renal radiofrequency ablation in acute and chronic po rcine models. Methods. Our study comprised two phases-an acute phase and a chronic phase. In the acute phase, bilateral laparoscopic renal radiofrequency ablation w as performed in 6 animals (12 renal units), which were euthanized immediate ly after surgery. In the chronic study, bilateral percutaneous renal radiof requency ablation was performed in 5 animals (10 renal units). One animal e ach was euthanized at postoperative day 3, 7, 14, 30, and 90. Results. Ultrasound-monitored laparoscopic (n = 12) and percutaneous (n = 1 0) radiofrequency ablations of the lower pole of the kidney were technicall y successful in each instance. No intraoperative complications occurred. in the survival experiments, the radiolesions showed gradual spontaneous reso rption and ultimate renal autoamputation, while maintaining pelvocalyceal i ntegrity as confirmed by ex vivo retrograde uretero-pyelogram. Serum creati nine and hematocrit remained stable in all survival animals. Postoperative complication occurred in 1 chronic animal with nonobstructive small bowel d ilation at autopsy. Conclusions. Laparoscopic and percutaneous renal radiofrequency ablation ar e technically feasible. The anatomic and physiologic sequelae of renal radi osurgery are favorable. Improved techniques of real-time monitoring of the evolving renal radiolesion are necessary. UROLOGY 56: 197-200, 2000. (C) 20 00, Elsevier Science Inc.