Tratamiento de las masas renales de pequeño tamaño mediante radiofrecuencia por laparoscopia

OBJECTIVES: To perform a bibliographic review of the laparoscopic approach for radiofrequency ablation of small renal masses. METHODS: For this review we used the Medline database. We reviewed the clinical guidelines of the American Urological Association, the European Association of Urology and other institutions. RESULTS: Radiofrequency ablation is a minimally invasive treatment in which a needle is introduced in the tumor once it is identified, and it produces an increase of temperature high enough to destroy tumor cells. This technique may be used by percutaneous approach, or during a laparoscopic approach. The choice of one technique or another depends on tumor site, closeness to the bowels or other organs and patient conditions. It would be indicated in patients with small tumors or important comorbidity who are not candidates for surgery. There are not randomized studies comparing these ablation techniques with the surgical techniques. There is no randomized study comparing the efficacy of percutaneous and laparoscopic techniques either but a metanalysis comparing them has been performed. CONCLUSIONS: The treatment of small renal masses keeps being surgical excision. Radiofrequency ablationrepresents an alternative for carefully selected patients due to its low morbidity and few complications. There are not long term efficacy studies to date. Laparoscopic radiofrequency ablation would be indicated in cases in which the percutaneous approach is complicated due to tumor site.