Nouvelles techniques pour le traitement chirurgical mini-invasif des tumeurs du rein

Partial nephrectomy has become a widely accepted treatment modality for small renal neoplasms (less than 4 cm). More recently new types of thermal therapies have been developped and proposed for in situ tissue destruction of small tumors such as cryotherapy, radiofrequency ablation, microwave irradiation and high intensity focalized ultrasound. The combination of thermal therapy with either laparoscopic or percutaneous surgery is particularly attractive and may be considered a minimally invasive treatment alternative to classic surgical tumor excision. Of the different forms of thermal therapy renal cryosurgery is the most widely studied and now available to our patients as part of a well controlled study protocol. Preliminary studies from the literature are promising but are limited to small patient groups and lack the necessary longterm results for final appreciation. In this report, we review the different forms of thermal therapy that are presently under investigation for the treatment of small renal tumors.