CT-Guided Percutaneous Cryoablation of Small Renal Masses: General Anesthesia Versus Conscious Sedation with Dexmedetomidine.

Abstract

Purpose: General anesthesia (GA) is often used during CT-guided percutaneous cryoablation (PCA) of renal tumors. This retrospective study compared GA to conscious sedation (CS), with dexmedetomidine and remifentanil, regarding theater time and hospital stay during PCA of renal tumors.

Materials and methods: This retrospective study reviewed 350 patients treated with PCA between January 1, 2015, and December 31, 2019. Associations were analyzed between the type of anesthesia and theater time, hospital stay, complications, and clinical outcomes.

Results: The cohort consisted of 148 patients who received PCA in GA (mean age 64.7 ± 13.4 years; 99 men) and 202 patients who received PCA in CS (mean age 66.7 ± 10.7 years; 142 men). Patients in the GA group had significantly longer theater times (mean 2.6 h ± 0.48) compared to their CS counterparts (mean 2.1 h ± 0.46; p < 0.001). Furthermore, the median length of hospital stay was significantly longer in the GA group (8.5 vs. 5.5 h, p < 0.001). In addition, patients in the GA group had significantly lower levels of consciousness in the recovery room compared to the CS group (p = 0.047). There were no differences between the groups regarding complications, graded on the CIRSE classification system (p = 0.463), or rate of incomplete ablation at three-month follow-up (p = 0.229).

Conclusion: Patients who undergo PCA of renal tumors under CS have significantly shorter theater time and length of hospital stay compared to patients who undergo PCA in GA, with no impact on complications or technical failure rate.

Level of evidence: 3, a retrospective cohort study.