Laparoscopic renal cryoablation: Impact on renal function and blood pressure

Objectives. To evaluate the renal function and blood pressure outcomes afte r laparoscopic renal cryotherapy. Laparoscopic renal cryoablation is a deve lopmental minimally invasive modality for the treatment of renal neoplasms. After cryotherapy, a segment of renal parenchyma is rendered ischemic/necr otic and left in situ. It is currently unknown whether this may trigger ren in overproduction and thus renin-mediated hypertension. Methods. Data are presented for 22 of 56 treated patients, each of whom com pleted a minimum follow-up of 6 months. The data were obtained from patient charts, phone interviews, and/or questionnaires. These results were statis tically compared over time by paired t tests. Results. The mean follow-up was 20.6 months. No significant differences wer e found between the preoperative and most recent postoperative serum creati nine (sCr) levels (1.13 and 0.91 mg/dL, respectively), systolic and diastol ic blood pressure values (135.6 versus 131.2 mm Hg and 78 versus 72.7 mm Hg , respectively), or in the estimated creatinine clearance (P <0.05). The nu mber or dose of anti hypertensive medications did not change during the fol low-up period for any patient. In 3 patients with a solitary kidney, the bl ood pressure and sCr values remained unchanged (mean preoperative sCr 1.43 mg/dL and mean postoperative sCr after a minimum of 6 months 1.33 mg/dL). Conclusions. Laparoscopic renal cryoablation did not have a deleterious imp act on renal function or blood pressure during a mean follow-up of 20.6 mon ths. UROLOGY 58: 357-361, 2001. (C) 2001, Elsevier Science Inc.