Abstract Book - 26th ESPU Congress, Joint Meeting with ICCS + SPU + AAP/SOU + AAPU + SFU

S20-10

(P)

LAPAROSCOPIC CRYOABLATION OF ANGIOMYOLIPOMAS IN ADOLESCENTS AND

YOUNG ADULTS: A REPORT OF 4 CASES ASSOCIATED WITH TUBEROUS

SCLEROSIS AND 1 CASE OF SPORADIC ORIGIN.

Karina TRELBORG

, Tommy K. NIELSEN

and L. Henning OLSEN

1) Aarhus University, Department of Clinical Medicine, Aarhus, DENMARK - 2) Aarhus University Hospital-Skeiby,

Paediatric Urology, Aarhus, DENMARK

PURPOSE

The present study reports the first series of laparoscopic cryoablation of renal angiomyolipomas (AML) in adolescents

and young adults.

MATERIAL AND METHODS

From October 2009 to September 2013 five patients at our institution were diagnosed with AML requiring treatment.

Four patients had tuberous sclerosis (TS) and one had AML of sporadic origin, all five patients underwent laparoscopic

cryoablation. Perioperative data were prospectively registered in a nation-wide laparoscopy database, follow-up data

collected from the patients' chart, all imaging was reassessed by independent radiologists.

RESULTS

Median age was 16 (13-27) years. Eight AMLs in five patients, with a median size of 3.9 (2.1-7.7) cm were treated.

Indication for intervention within the TS group was prophylactic due to tumor size and rapid growth. The patient with

sporadic AML was treated due to tumor size and a former bleeding episode. From time of diagnosis until intervention the

patients with TS were followed with renal imaging for a median time of 117 (1-140) months. After cryoablation AML

status was followed by CT and MRI for a median follow up time of 37 (6-59) months. On follow-up imaging, all lesions

showed a reduction in tumor size, and no regrowth was recognized.

The procedure was well tolerated, with few minor intraoperative complications and all patients scored zero in the

Clavien-Dindo classification as no postoperative complications occurred.

CONCLUSIONS

Treating AMLs with laparoscopic cryoablation appears to be a safe and feasible nephron-sparing approach in adolescents

and young adults, thus supporting the future use of cryoablation in this patient Group.