Re: Percutaneous and laparoscopic cryoablation of small renal masses. D. S. Finley, S. Beck, G. Box, W. Chu, L. Deane, D. J. Vajgrt, E. M. McDougall and R. V. Clayman. J Urol 2008; 180: 492-498.

摘要

Patient age can be an influential factor in the success rate of surgery, especially with regard to comorbidities. It is arguable that the differences mentioned in this article could be due to patient age, since age differences between the 2 groups are not specified. Table 1 in the article shows that there were 24 lesions treated with laparoscopic cryoablation (LCA) in 19 patients, which indicates that there were patients with multiple tumors. The actual reason for higher hemorrhage rates experienced in the LCA group could be that a portion of patients in this group were treated with more than 1 probe. However, this detail is not stated clearly in the article. Although there may be no significant difference between the percutaneous cryoablation (PCA) and LCA groups, we can observe higher hemorrhage rates in the LCA group, since multiple interventions were applied on multiple tumors only in this group. If a new statistical analysis were conducted after removing the patients with multiple probes from both groups, hemorrhage rates, as stated by the authors, would be 0%. Thus, we can say that hemorrhage is due to the use of multiple probes rather than the type of treatment approach used.