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Percutaneous hydrodissection for thermoprotection during cryoablation of periureteric and pyeloureteric junction renal cell carcinomas

  • Interventional Radiology
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Objective

To report our experience of percutaneous image-guided cryoablation of renal tumors located within 10 mm of the pyeloureteric junction (PUJ) and/or ureter, with hydrodissection as a stand-alone thermoprotective technique.

Materials and methods

All patients who were offered combined hydrodissection and cryoablation of the PUJ/ureter to treat stage-1 renal cell carcinoma were retrospectively reviewed. Data regarding patients, lesions, and outcomes were collected.

Results

Twenty tumors in 20 patients (13 males:7 females) with a mean age of 74.4 ± 7.5 were included. Mean tumor size was 27.6 ± 6.4 mm. Nearby vulnerable structure(s) were identified as the ureter in 5/20 cases, the PUJ in 8/20 cases and both the PUJ and the ureter in the remaining 7/20 cases (35%) cases. Mean minimal distance between the tumor and the vulnerable organ(s) was 4.8 ± 2.6 mm (range 0–10). A mean of 1.7 ± 0.6 spinal needles were used per intervention with a mean time to complete hydrodissection of 18.6 ± 13.4 min. Primary and secondary technical efficacy rates were 90% and 95%, respectively. Mean follow-up was 23.1 ± 9.2 months. There were no immediate or delayed complications, in particular no urothelial strictures. Two tumor recurrences occurred during follow-up, with a time to disease progression of 13 and 31 months, respectively.

Conclusion

hydrodissection of the PUJ/ureter to prevent thermal injury during cryoablation is an effective technique and does not seem to compromise the efficacy of ablation at short or mid-term follow-up.

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Authors and Affiliations

  1. Department of Interventional Radiology, Nouvel Hôpital Civil, 1, Place de l’Hôpital, 67096, Strasbourg Cedex, France

    Julia Weiss, Julien Garnon, Roberto Luigi Cazzato, Pierre Auloge, Jean Caudrelier, Emanuele Boatta, Pierre De Marini, Guillaume Koch & Afshin Gangi

  2. School of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK

    Danoob Dalili

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  1. Julia Weiss
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  2. Julien Garnon
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  3. Roberto Luigi Cazzato
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Correspondence to Julia Weiss.

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Julien Garnon & Afshin Gangi are proctors for BTG Galil. All other authors have no conflicts of interest.

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Weiss, J., Garnon, J., Cazzato, R.L. et al. Percutaneous hydrodissection for thermoprotection during cryoablation of periureteric and pyeloureteric junction renal cell carcinomas. Abdom Radiol 46, 1179–1187 (2021). https://doi.org/10.1007/s00261-020-02760-8

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  • DOI: https://doi.org/10.1007/s00261-020-02760-8

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