BACKGROUND: The kidney is one of the most frequently injured intraabdominal organs. In this study, we investigated the efficacy and safety of radiofrequency ablation (RFA) as a kidney-preserving hemostatic technique for grade IV renal trauma. METHODS: A grade IV injury was induced in the right kidney of 12 Landrace pigs. Then RFA was applied around the injury in 10 animals until hemostasis was achieved; two animals were not treated (control group). The treated animals were killed humanely on days 0, 3, 7, 14 and 21 and examined. The kidneys were subjected to histologic and radiologic examination. RESULTS: The two untreated animals died from hypovolemic shock. Hemostasis was achieved in all treated animals. We had no operative deaths and no morbidity. No blood, pus, urine, or other fluid was found at the time of death. In one animal, a fistulous lesion leading to the collecting system was identified, but no urine leakage was observed. At histology, the ablated areas were found to consist of three zones: an inner necrotic one, a zone of neutrophils digesting necrotic tissue, and an outer zone with possibly reversible damage. CONCLUSIONS: Radiofrequency ablation is an efficient and safe hemostatic method for grade IV renal trauma. Further study is needed to investigate the possible application of this method to humans and its percutaneous or laparoscopic use.
BACKGROUND: The kidney is one of the most frequently injured intraabdominal organs. In this study, we investigated the efficacy and safety of radiofrequency ablation (RFA) as a kidney-preserving hemostatic technique for grade IV renal trauma. METHODS: A grade IV injury was induced in the right kidney of 12 Landrace pigs. Then RFA was applied around the injury in 10 animals until hemostasis was achieved; two animals were not treated (control group). The treated animals were killed humanely on days 0, 3, 7, 14 and 21 and examined. The kidneys were subjected to histologic and radiologic examination. RESULTS: The two untreated animals died from hypovolemic shock. Hemostasis was achieved in all treated animals. We had no operative deaths and no morbidity. No blood, pus, urine, or other fluid was found at the time of death. In one animal, a fistulous lesion leading to the collecting system was identified, but no urine leakage was observed. At histology, the ablated areas were found to consist of three zones: an inner necrotic one, a zone of neutrophils digesting necrotic tissue, and an outer zone with possibly reversible damage. CONCLUSIONS: Radiofrequency ablation is an efficient and safe hemostatic method for grade IV renal trauma. Further study is needed to investigate the possible application of this method to humans and its percutaneous or laparoscopic use.
Authors: I S Gill; T H Hsu; R L Fox; A Matamoros; C D Miller; R F Leveen; M T Grune; G T Sung; M E Fidler Journal: Urology Date: 2000-08-01 Impact factor: 2.649
Authors: E E Moore; S R Shackford; H L Pachter; J W McAninch; B D Browner; H R Champion; L M Flint; T A Gennarelli; M A Malangoni; M L Ramenofsky Journal: J Trauma Date: 1989-12
Authors: Hunter Wessells; Donald Suh; James R Porter; Frederick Rivara; Ellen J MacKenzie; Gregory J Jurkovich; Avery B Nathens Journal: J Trauma Date: 2003-03
Authors: E Pikoulis; E Felekouras; I Papaconstantinou; M Kontos; E Prassas; I Griniatsos; C Bacoyiannis; P Pappa; A Papalois; C Tsigris; A Giannopoulos; E Papalambros; J Bramis; E Bastounis Journal: Surg Endosc Date: 2005-07-21 Impact factor: 4.584