Purpose
We present a retrospective study where we assessed the safety and effectiveness of external hand compression to displace adjacent bowel loops during MRI-guided percutaneous cryoablation of renal tumors.
Material and methods
Fifteen renal tumors (mean diameter: 2.4 cm; range: 1.4-4.6 cm) in 14 patients (6 women, 8 men; mean age: 72 years) were treated with MRI-guided percutaneous cryoablation. All tumors were adjacent to bowel; colon (n=13); colon and small bowel (n=2). These were displaced by external manual compression. To analyze effectiveness, mean distance between tumor margin and bowel before and after the maneuver were compared and analyzed using paired Student’s t test. Minimum distance between iceball edge and adjacent bowel with external manual displacement during freezing was also measured. Post-procedural MR imaging for adjacent bowel wall thickening and focal fluid collections, and patients’ clinical and imaging follow-up was analyzed to assess safety.
Results
Mean distance between tumor margin and closest adjacent bowel increased from 0.8 cm (range: 0-2 cm) before external manual compression to 2.6 cm (range: 1.6-4.1 cm) with manual displacement (p<0.01). Mean minimum distance between iceball edge and closest adjacent bowel during the procedures was 1.6 cm (range: 0.5-3.5 cm). No bowel injury was encountered. Twelve of 15 tumors had follow-up (mean: 10 months) that showed no tumor recurrence.
Conclusion
External hand compression to displace bowel loops can be used safely and effectively during MRI-guided percutaneous cryoablation of renal tumors adjacent to bowel.