RETROPERITONEAL LAPAROSCOPY RADIOFREQUENCY ABLATION FOR RENAL CANCER WITH TUMORS SMALLER THAN 3 CM: A REPORT OF TWO CASES

Abstract

Objective: This study aims to evaluate the intermediate results of retroperitoneal laparoscopic radiofrequency ablation (LRFA) in the treatment of renal cell carcinoma with tumor size less than 3 cm, based on two case reports. Additionally, a comprehensive retrospective literature review is conducted to further explore the efficacy and technical aspects of this technique. Materials and Methods: Retroperitoneal laparoscopic radiofrequency ablation was performed on two renal tumors smaller than 3 cm in two patients. Follow-up studies included physical examinations, serum creatinine levels, and contrast-enhanced computed tomography (CT) to assess the pathological criteria for complete ablation. Recurrence was defined as contrast enhancement on imaging studies at 3 months or lesion growth on subsequent imaging. Results:  Two patients (one male and one female, aged 61 and 48 years, respectively) underwent the procedure. Tumor sizes were 23 mm and 28 mm, located at the upper pole of the right kidney and the mid-pole of the left kidney, respectively. Contrast-enhanced computed tomography (CT) findings were suspicious for renal cell carcinoma. One patient underwent intraoperative biopsy, which confirmed renal malignancy. The total operative times were 35 and 45 minutes, respectively, while the radiofrequency ablation times were 20 and 30 minutes. No intraoperative or postoperative complications were observed. The length of postoperative hospital stay was 3 days for both patients. Follow-up at 18 months and 9 months, respectively, demonstrated tumor shrinkage on contrast-enhanced CT, leaving only small scars, with no evidence of recurrence. Serum creatinine levels remained stable compared to preoperative values. Conclusion: Retroperitoneal laparoscopic radiofrequency ablation appears to be a safe and effective treatment option for renal tumors smaller than 3 cm. At 18-month follow-up, oncologic outcomes showed no evidence of recurrence.