Analysis of the clinical case and computer simulation of cryoablation of multifocal renal cell carcinoma

Background. Multifocal renal cancer considerably surpasses a unifocal lesion in malignancy degree that, in turn, predetermines radical approach to treatment. At the same time, a series of the conducted clinical trials showed that in group of carefully selected patients performance of alternative low-invasive methods of treatment is possible. Tactics of surgical treatment of patients with multifocal renal cell carcinoma still remains a discussion subject that provides analysis for each case.

Aim. Development of a technique of carrying out cryosurgical operations by the analysis and computer modeling of a certain clinical case.

Material and methods. Experimental justification of the regimen choice of cryoinfluence dos- age, a clinical case of a cryoablation of multifocal renal cell carcinoma and the subsequent analysis of regimens of the carried-out dosage with use of a program complex of a final ultimate analysis (Ansys) are described. Based on a certain clinical case the prospective research of a possibility to use computer modeling for planning of the course of operation is conducted.

Results. The received results of computer modeling are compatible to results of real operation when comparing areas of a cryonecrosis and hypothermia.

Conclusions. Now cryoablation is an alternative treatment method for patients with renal cell carcinoma and has rather small amount of contraindications: anticipated life expectancy less than 1 year, metastases, a tumor locating in the field of hilar and also central collective system or proximal ureter. Cryoablation of a kidney is shown to be mostly indicated for patients of high surgical risk with small tumour (no more than 4 cm), with serious concominant diseases or patients refusing a nephrectomy. Improvement of ways to choose cryointervention regimen and creation of agents for preoperative forecasting of temperature fields for search of optimum provisions of cryoneedles will allow to increase accuracy of low-temperature influence substantially.

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