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Waleed A Hasan

Publications and source records attributed to Waleed A Hasan.

5 recordsLinked to original sources

Renal cryoablation: outcome at 3 years.

PURPOSE: We report intermediate term oncological followup data on 56 patients undergoing laparoscopic renal cryoablation, of whom each completed a 3-year followup. MATERIALS AND METHODS: Since September 1997, 56 patients undergoing laparoscopic renal cryoablation have completed a followup of 3 years each. The postoperative followup protocol comprised serial magnetic resonance imaging (MRI) at 1 day, months 1, 3, 6, 12, 18 and 24, and yearly thereafter for 5 years. Computerized tomography guided needle biopsy of the cryolesion was performed 6 months postoperatively and repeated if MRI findings were abnormal. Followup data were obtained prospectively. RESULTS: For a mean renal tumor size of 2.3 cm mean intraoperative size of the created cryolesion was 3.6 cm. Sequential mean cryolesion size on MRI on postoperative 1 day, and at 3 and 6 months, and 1, 2 and 3 years was 3.7, 2.8, 2.3, 1.7, 1.2 and 0.9 cm, representing a 26%, 39%, 56%, 69% and 75% percent reduction in cryolesion size at 3 and 6 months, and 1, 2 and 3 years, respectively. At 3 years 17 cryolesions (38%) had completely disappeared on MRI. Postoperative needle biopsy identified locally persistent/recurrent renal tumor in 2 patients. In the 51 patients undergoing cryotherapy for a unilateral, sporadic renal tumor 3-year cancer specific survival was 98%. There was no open conversion, kidney loss, urinary fistula, dialysis requirement, or perirenal or port site recurrence in any patients. CONCLUSIONS: Three-year outcomes following renal cryoablation are encouraging. Longer term (5-year) data are necessary to determine the proper place of renal cryotherapy among minimally invasive, nephron sparing options.

Adult↗

Laparoscopic live donor nephrectomy.

With the number of patients presently awaiting renal transplantation exceeding the number of cadaveric organs available, there is an increasing reliance on live renal donation. Of the 11,869 renal transplants performed in 2002 in the US, 52.6% were living donors from the United Network for Organ Sharing Registry. Renal allografts from living donors provide: superior immediate long-term function; require less waiting time and are more cost-effective than those from cadaveric donors. However, anticipation of postoperative pain and temporary occupational disability may dissuade many potential donors. Additionally, some recipients hesitate to accept a living donor kidney due to suffering that would be endured by the donor. It is a unique medical situation when a young, completely healthy donor undergoes a major surgical procedure to provide an organ for transplantation. It is mandatory to offer a surgical technique, which is safe and with minimal complications. It is also obvious for any organ transplantation, that the integrity of the organ remain intact, thus, enabling its successful transplantation into the recipient. An acceptably short ischemia time and adequate lengths of ureter and renal vasculature are favored. Many centers are performing laparoscopic live donor nephrectomy in an effort to ease convalescence of renal donors. This may encourage the consideration of live donation by recipients and potential donors.

Humans↗

Laparoscopic surgery for renal cell carcinoma.

New minimally invasive technologies are currently being applied to the management of renal cell carcinoma in an effort to decrease operative time, pain, morbidity and hospital stay. Foremost among these is the burgeoning role of laparoscopy in tumor destruction and complete in vivo resection. The primary modalities in clinical use today are laparoscopic radical nephrectomy, laparoscopic partial nephrectomy, laparoscopic renal cryoablation and laparoscopic radiofrequency ablation. Most initial reports include only highly selected patients with unifocal, small, exophytic, peripheral lesions away from the collecting system. As experience with these techniques increases, larger and more difficult lesions are being approached laparoscopically, with promising anecdotal results reported. Laparoscopic access to the kidney may be retroperitoneal or transperitoneal. Complete tumor destruction with maximal preservation of unaffected nephrons remains the goal. Herein, an update on laparoscopic surgery for renal cell carcinoma is presented. For each procedure, the current indications and contraindications, perioperative data, complications and oncological outcomes are described. In the future, it appears likely that laparoscopy will play a major role in the established treatment options for renal cell carcinoma, with open surgery being reserved for specific indications.

Carcinoma, Renal Cell↗