PURPOSE: We determined the short-term and long-term sequelae of intentional cryoablation of the renal pelvicaliceal system and evaluated whether continuous irrigation of the renal pelvicaliceal system with warm saline protects it against @entity130 . MATERIALS AND METHODS: In 12 @entity1707 open bilateral renal cryoablation using an argon gas based system was performed to create a cryolesion in the lower pole that was intentionally extended into the collecting system. A single cryoprobe was used to create a 3 cm ice ball in group 1 (6 animals) and 2, 3 mm cryoprobes were used to create a 4.5 cm ice ball in group 2 (6). In all 12 right kidneys pelvicaliceal warming (range 38C to 42C) was performed using continuous retrograde saline irrigation through an indwelling 5Fr ureteral catheter. In all 12 @entity8 was performed without pelvicaliceal warming. Real-time confirmation of caliceal involvement by the cryolesion was obtained by retrograde ureteropyelogram. Immediately after @entity130 6 left and 6 right kidneys were harvested for histology and the animals with a solitary kidney were followed for 1 to 3 months. RESULTS: Nadir cryoprobe tip temperature was -136C with a mean cryolesion time of 10.5 minutes. Cryolesion size was comparable in the right vs left kidneys in groups 1 and 2 (2.9 vs 3.0 and 4.7 vs 4.6 cm, respectively). Similarly cryoablation time was comparable between the right and left kidneys in groups 1 and 2 (11.3 vs 10.8 and 11.9 vs 12.2 minutes, respectively). Two animals died of @entity1174 (1) and wound dehiscence (1). In all 10 surviving animals no instance of urinary extravasation was noted. At 1-month followup regrowth of normal urothelium occurred with some scarring of the lamina propria or underlying smooth muscle. Adjacent renal parenchyma was replaced by @entity82 . At 3 months the cryo-injured collecting system was completely healed with a @entity82 . There were no appreciable histological differences between the kidneys with or without warm pelvicaliceal irrigation. CONCLUSIONS: Our data suggest that absent physical puncture injury of the collecting system with the cryoprobe tip the cryodamaged renal collecting system heals by secondary intention in a watertight manner. These data have clinical relevance for facilitating cryoablation of a small, localized, central @entity703 in proximity to the pelvicaliceal system.

Effect of intentional XXXX to the renal collecting system.

@entity1707 :: ('9823', 'Species') :: ['swine'] @entity8 :: ('MESH:D007674', 'Disease') :: ['left kidneys cryoablation'] @entity82 :: ('MESH:D005355', 'Disease') :: ['fibrous scar'] @entity1174 :: ('MESH:D011015', 'Disease') :: ['aspiration pneumonia'] @entity130 :: ('MESH:D014947', 'Disease') :: ['cryo-injury'] @entity703 :: ('MESH:D007680', 'Disease') :: ['renal tumor']
@entity130 :: (MESH:D014947,Disease) :: ['cryo-injury']
