Introduction: Surgical resection is the standard treatment for renal cell carcinoma (RCC). Challenging cases of laparoscopic partial nephrectomy might convert to open surgery and even end in radical nephrectomy.
Thermal ablation is well established procedure which indicted in patients with co-morbid illness who cannot undergo surgery.
Purpose: To describe Thermoablative technique as curative treatment for RCC in challenging cases.
Material and methods: Form April 2012 to May 2019, 67 ablative procedures on renal masses were performed, in 64 patients (47 males, 17 females, average age 67, age range 38-84).
At this work we included 19 patients who underwent ablation treatment that require specific ablative technique or prevented challenging operation and radical nephrectomy.
Results: Thermoablative procedure performed in 13 patients with renal lesion who underwent hidro-dissection due to adjusted bowel loop, genicofemoral nerve and renal artery. Two patients with cystic lesion underwent ablation with microwave. Two patients with intra-parenchymatic tumor underwent theroablative procedure instead of radical nephrectomy and two elderly patients with co- morbid illnesses and tumor larger then 3cm.
There were no complication during or after the procedures and in a follow up of 4-86 months (average 31 months) we observed one RCC recurrence which treated with a second ablation, patient is now free of tumor for 72 months.
Conclusion: With careful planning and multidisciplinary approach for patients selection Thermal ablation can provide effective method of treatment for RCC which avoid surgical complication and spare radical nephrectomy. Thermoablative procedure should be included in the arsenal of treatment in challenging patient and challenging tumor location.
