• Am. J. Med. Sci. · Sep 2024

    Pleural Complications in Patients with Renal Cell Carcinoma Undergoing Percutaneous Cryoablation: A Retrospective Analysis of its Incidence and Risk Factors.

    • Ibrahim Khatim, Isam Albaba, Marc A Judson, Kurt Hu, Sana Ali, Harpreet Singh, Khezar Syed, Moses Koo, Timothy Yung, Paul Feustel, Ramkrishna Patel, Gary Siskin, and Amit Chopra.
    • Department of Internal Medicine, Albany Medical Center, Albany, NY, United States.
    • Am. J. Med. Sci. 2024 Sep 16.

    RationaleObservations from our clinical practice indicate a notable occurrence of pleural complications post-percutaneous renal cryoablation (PRC).ObjectiveTo identify the incidence of pleural complications following PRC and potential risk factors associated with post-procedural pleural complications.Materials And MethodsThis was a retrospective cohort analysis of patients undergoing PRC at two tertiary hospital systems between 2016 and 2022. Patient characteristics, radiological and clinical data, and procedure techniques were collected in a database to identify potential risk factors.ResultsA total of 285 patients were identified who underwent 312 PRC procedures during the specified inclusion period. Among these, 10 procedures (3.2 %) led to pleural complications, all manifesting as pleural effusions. Of these complications, 3 patients (1 %) required pleural drainage. Factors associated with an increased risk of pleural complications included a larger mean tumor size (4.3 cm vs 2.7 cm, P = <0.001), cryoprobe applicator entry at the T10-T11 level as opposed to lower sites (P = 0.029), and a higher median number of cryoprobe applicators employed (3.5 vs 2.0, P = 0.001). Moreover, individuals who experienced pleural complications had a longer median hospital stay (4.0 vs 0, P ≤ 0.001) and a higher rate of blood transfusions (40% vs 0.7 %, P ≤ 0.001).ConclusionPleural complications from percutaneous renal cryoablation are rare. To further reduce the risk, higher insertion points (above T12) and utilizing more than two cryoprobe applicators should be avoided when feasible. Pleural complications in patients with new respiratory symptoms after PRC should be considered.Copyright © 2024. Published by Elsevier Inc.

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