Abstract
Introduction
Variability exists among institutions and physicians regarding the use of prophylactic antibiotics for ablation of renal tumors. The literature was reviewed for infectious complications vis-à-vis the reported use of prophylactic antibiotics for tumor ablation of renal neoplasms.
Materials and Methods
PubMed was searched for articles reporting radiofrequency ablation, cryoablation, and microwave ablation of renal masses, both by percutaneous and laparoscopic approaches. Data regarding potentially infectious outcomes, prophylactic antibiotic use or not, patient information, lesion characteristics, and procedural specifics were extracted from relevant articles.
Results
Fifty-one articles met the inclusion criteria. Potentially infectious complications occurred in 74/6952 patients (1.06%) if fever is included, but only 29 patients (0.42%) if fever is excluded. Prophylactic antibiotics were reported in 373 patients and were not mentioned in 6579 patients. The incidence of fever was higher with the laparoscopic radiofrequency ablation and cryoablation compared to the percutaneous approach (p < 0.001).
Conclusion
Prophylactic antibiotics seldom are used and/or reported in renal tumor ablation, and when they are, the antibiotic regimens vary widely. Even so, infectious complications in renal tumor ablation are uncommon. The similar and very low rates of infectious outcomes among ablation types and the two access approaches (laparoscopic and percutaneous) suggest that prophylactic antibiotics for routine renal tumor ablation are unnecessary.
Similar content being viewed by others
References
Shin BJ, Chick JFB, Stavropoulos SW. Contemporary status of percutaneous ablation for the small renal mass. Curr Urol Rep. 2016;17:1–9.
Venkatesan AM, Wood BJ, Gervais DA. Percutaneous ablation in the kidney. Radiology. 2011;261:375–91.
Venkatesan AM, Kundu S, Sacks D, et al. Practice guideline for adult antibiotic prophylaxis during vascular and interventional radiology procedures. J Vasc Interv Radiol. 2010;21:1611–30.
Krokidis ME, Orsi F, Katsanos K, Helmberger T, Adam A. CIRSE guidelines on percutaneous ablation of small renal cell carcinoma. Cardiovasc Interv Radiol. 2017;40:177–91.
Sutcliffe JA, Briggs JH, Little MW, et al. Antibiotics in interventional radiology. Clin Radiol. 2015;70:223–34.
Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.
Sacks D, McClenny TE, Cardella JF, Lewis CA. Society of interventional radiology clinical practice guidelines. J Vasc Interv Radiol. 2003;14:S199–202.
Wah TM, Irving HC, Gregory W, Cartledge J, Joyce AD, Selby PJ. Radiofrequency ablation (RFA) of renal cell carcinoma (RCC): experience in 200 tumours. BJU Int. 2014;113:416–28.
Burk JF. The effective period of preventive antibiotic action in experimental incisions and dermal lesions. Surgery. 1961;50:161–8.
Guglielmo BJ, Hohn DC, Koo PJ, Hunt TK, Sweet RL, Conte JE Jr. Antibiotic prophylaxis in surgical procedures: a critical analysis of the literature. Arch Surg. 1983;118:943–55.
Bratzler DW, Dellinger EP, Olsen KM, et al. Clinical practice guidelines for antimicrobial prophylaxis in surgery. Am J Health Syst Pharm. 2013;70:195–283.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare that they have no conflict of interest.
Ethics Approval
For this type of study formal consent is not required. This article does not contain any studies with human participants or animals performed by any of the authors.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Crawford, D., vanSonnenberg, E. & Kang, P. Infectious Outcomes from Renal Tumor Ablation: Prophylactic Antibiotics or Not?. Cardiovasc Intervent Radiol 41, 1573–1578 (2018). https://doi.org/10.1007/s00270-018-2043-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00270-018-2043-8