Zeltser IS et al. (2008) Intermediate-term prospective results of radiofrequency-assisted laparoscopic partial nephrectomy: a non-ischaemic coagulative technique. BJU Int 101: 36–38

The widespread adoption of laparoscopic partial nephrectomy (LPN) for the treatment of small renal tumors has been hindered by its inherent technical difficulties. Radiofrequency-assisted LPN (RF-LPN), a novel technique that simplifies standard LPN, involves coagulation of the tumor with a radiofrequency probe followed by laparoscopic excision; no occlusion of the renal hylum is required (thus eliminating warm ischemia), and only fibrin glue is used to prevent urinary leaks. Having previously reported good short-term oncologic outcomes with this technique, Zeltser and colleagues now report the first intermediate-term results from a prospective database of patients who underwent RF-LPN for renal masses.

The authors identified 30 patients (mean age 56 years, range 21–75 years) who underwent RF-LPN for small renal masses (mean size 1.9 cm). Follow-up evaluations, consisting of abdominal CT or MRI and chest X-ray, were performed at 6 and 12 months postoperatively and annually thereafter.

Of the 32 masses identified, 29 had ≥6 months' follow-up data (mean 31 months, range 6–60 months) and were included in oncologic outcome analysis. Mean intraoperative blood loss was 80 ml; no procedures were converted to radical nephrectomy or open surgery, and none required hylar clamping. No local tumor recurrence or progression to metastatic disease was observed at the latest follow-up, yielding a cancer-specific survival of 100%. Postoperative complications included transiently elevated plasma creatinine levels (n = 2), hydrocalyx (n = 1) and mild port-side cellulitis (n = 1).

The authors conclude that RF-LPN shows good intermediate-term cancer control and low postoperative complication rates.