Percutaneous renal cryoablation in obese and morbidly obese patients

摘要

Objective To compare percutaneous renal cryoablation complications and outcomes in obese and morbidly obese vs nonobese patients. Methods Three hundred eighty-nine percutaneous cryoablation procedures were performed in 367 patients for treatment of 421 renal masses at our institution between 2003 and 2012. Patients were categorized into 3 groups on the basis of body mass index (BMI): nonobese (BMI 30.0 kg/m2), obese (BMI 30.0-39.9 kg/m 2), and morbidly obese (BMI ≥40.0 kg/m2). Each group was retrospectively analyzed for major complications (Clavien ≥grade 3) and oncologic outcomes. Results One hundred eighty-nine renal cryoablation procedures (48.6%) were performed on nonobese patients, 161 (41.4%) on obese patients, and 39 (10.0%) on morbidly obese patients. Eleven (5.8%) major complications occurred in nonobese patients, 15 (9.3%) in obese patients, and 3 (7.7%) in morbidly obese patients. As such, there was no significant difference in the rate of major complications in obese (P =.23) or morbidly obese (P =.67) compared with nonobese patients. There was 1 ablation-related death from complications of urosepsis. Thirteen local treatment failures were identified, including 5 technical failures and 8 local tumor recurrences during median imaging follow-up of 18 months (interquartile range: 8-36). Six local treatment failures (3.2%) occurred in nonobese patients, 5 (2.9%) in obese patients, and 2 (4.8%) in morbidly obese patients. Again, no significant difference was noted in local treatment failure rate between obese (P =.96) or morbidly obese (P =.57) compared with nonobese patients. Conclusion Percutaneous renal cryoablation complication rates and short-term outcomes in obese and morbidly obese patients are similar to those in nonobese patients.