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kết quả có thể là do kinh nghiệm và tiến bộ công nghệ trong thiết lập này. Sử dụng phổ quát của một ống thông niệu đạo nóng lên hiệu quả trong tất cả các trung tâm đã dẫn đến giảm đáng kể trong bệnh tật. Việc sử dụng các thiết bị này ban đầu bị hạn chế bởi các Quản Lý Thực Phẩm và Dược Phẩm | Renal Cryoablation 123 Table 2. Intraoperative data Case Operative time min Probe mm Thermocouple C Freeze 1 min Freeze 2 min 1 205 5 2 -40.2 10 11 2 205 5 1 -32.0 10 10 3 182 5 1 -12.0 13 12 4 170 3 1 -21.6 10 10 5 209 5 1 -23.7 15 12 6 240 3 1 -50.7 7 5 7 181 5 1 -34.9 10 12 8 124 5 1 -30.7 12 13 9 210 5 1 -26.3 8 20 10 215 5 1 -31.0 12 10 11a 240 3 1 15 15 12 118 5 1 -64.1 10 12 13 208 5 1 -27.6 17 10 14 165 5 1 -12.8 12 14 Mean 194 32 -29.8 11.5 2.8 11.9 3.3 a Case 11 underwent a CT-guided percutaneous procedure Table 3. Postoperative data Case No. of analgesics Return to normal activity days Complications Follow-up mo Recurrence 1 1 4 16 2 3 5 16 3 0 5 15 4 1 4 15 5 2 9 Ureteral injury 13 Local 6 0 5 12 7 0 6 12 8 0 4 11 9 2 4 11 10 0 4 9 11a 0 3 5 12 0 4 4 13 0 4 2 14 0 4 1 Mean 0.6 4.8 1.5 10.1 5.2 a Case 11 underwent a CT-guided percutaneous procedure 124 K. Nakagawa and M. Murai POD -1 1 3 POD Fig. 6. Renal function. Cryoablation did not affect renal function.BUN Blood urea nitrogen s-CR serum creatinine POD post operative day Pre ope. Day2 3 months 6 months Fig. 7. Follow-up with serial CT Case 2 . The ablated lesion was not enhanced and became smaller on follow-up Renal Cryoablation 125 Pre ope. 3 months Fig. 8. Local recurrence in Case 5. An enhanced lesion was recognized in the ablated area after 3 months of follow-up 6 months months and renal function was well preserved over the period. Seven patients underwent needle biopsy 6 months after cryoablation and there were no findings of malignancy. However one patient who had a 35-mm tumor ablated with one 5-mm probe was diagnosed as having a local recurrence on CT after 3 months Fig. 8 and he underwent laparoscopic radical nephrectomy 6 months after cryoablation. Discussion The laparoscopic approach provided superior operative exposure and good ultrasonographic exposure. We were able to achieve correct placement of the cryoprobe in laparoscopic cryoablation and the results for tumors less than 3 cm in .
