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9 - Ablation of renal cancer

Published online by Cambridge University Press:  08 August 2009

By
Elizabeth E. Rutherford  and
David J. Breen
Edited by
Uday Patel
Elizabeth E. Rutherford
Affiliation:
Department of Radiology, Southampton University Hospitals, Southampton, UK
David J. Breen
Affiliation:
Department of Radiology, Southampton University Hospitals, Southampton, UK
Uday Patel
Affiliation:
St George's Hospital, London
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Summary

Introduction

Image-guided ablation is playing an increasingly important role in the management of small renal tumors. The potential benefits of image-guided ablation over traditional surgery include decreased morbidity and inpatient stay, decreased costs and the potential to treat patients who are poor surgical candidates by a minimally invasive approach. All available ablation techniques are based around the principle of utilizing thermal energy (whether it be hot or cold) to destroy tumor tissue. The aim of all ablation methods is to destroy malignant cells by invoking and maintaining cytotoxic temperatures within a tumor, including an adequate margin of surrounding normal tissue.

Cryotherapy

Cryotherapy has been used for many decades but only recently has there been a resurgence of interest in this technique as a result of the introduction of narrow gauge Argon probes (rather than the historical larger nitrogen probes) enabling treatment via a percutaneous approach. Multiple probes are inserted into the target lesion (either under imaging guidance or direct vision as an open surgical or laparoscopic procedure) and during the freeze cycle, an ice ball develops over approximately 15 minutes. Cryoablation uses multiple freeze–thaw cycles and requires temperatures of at least − 20 to − 30 ℃ to induce lasting tissue damage. There are several theories as to the mechanism of tissue destruction. These include protein damage as the cell dehydrates in response to freezing, damaging the cell membrane and intracellular enzymes. The formation of ice crystals within a cell also damages the intracellular organelles and cell membrane.

Type
Chapter
Information
Carcinoma of the Kidney , pp. 168 - 184
Publisher: Cambridge University Press
Print publication year: 2007

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References

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  • Ablation of renal cancer
    • By Elizabeth E. Rutherford, Department of Radiology, Southampton University Hospitals, Southampton, UK, David J. Breen, Department of Radiology, Southampton University Hospitals, Southampton, UK
  • Edited by Uday Patel, St George's Hospital, London
  • Book: Carcinoma of the Kidney
  • Online publication: 08 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545436.011
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  • Ablation of renal cancer
    • By Elizabeth E. Rutherford, Department of Radiology, Southampton University Hospitals, Southampton, UK, David J. Breen, Department of Radiology, Southampton University Hospitals, Southampton, UK
  • Edited by Uday Patel, St George's Hospital, London
  • Book: Carcinoma of the Kidney
  • Online publication: 08 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545436.011
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Ablation of renal cancer
    • By Elizabeth E. Rutherford, Department of Radiology, Southampton University Hospitals, Southampton, UK, David J. Breen, Department of Radiology, Southampton University Hospitals, Southampton, UK
  • Edited by Uday Patel, St George's Hospital, London
  • Book: Carcinoma of the Kidney
  • Online publication: 08 August 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545436.011
Available formats
×