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经皮冷循环射频消融治疗T1a肾细胞癌
Percutaneous cool-tip radiofrequency ablation of T1a renal cell carcinoma
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DOI:
作者:
王光春
WANG Guangchun
作者单位:
同济大学附属第十人民医院
Department of Urology, Shanghai Tenth People’s Hospital
关键词:
射频消融;肾癌;冷循环电极;疗效
Radiofrequency; Renal cell carcinoma; Cool-tipped electrodes; Therapeutic effects
摘要:
目的 探讨经皮冷循环射频消融治疗T1a肾细胞癌的安全性和疗效。方法 对15例T1aN0M0单发肾细胞癌初诊患者实施经皮冷循环射频消融治疗。肿瘤位于易于经皮接近的部位,远离肠管和大血管。肿瘤位于左肾6例,右肾9例。肿瘤平均直径2.7±1.1 cm(1.1~3.9cm)。术后采用增强CT、超声造影定期随访。结果 15例均成功接受经皮冷循环射频消融治疗,无严重手术并发症,术后第2天出院。术后1个月,15个肾癌病灶中,完全消融13个,消融不全2个,完全消融率86.7%(13/15)。血红蛋白、红细胞沉降率、患侧肾小球滤过率较术前无明显变化(P>0.05)。术后3个月,病灶完全坏死14例、部分坏死1例。随访时间2~22个月,中位数9.3个月,15例均生存,无局部及远处复发病例。结论 经皮冷循环射频消融治疗T1a肾细胞癌是安全、有效和微创的。
Objective To investigate the safety and therapeutic effects of percutaneous cool-tip radiofrequency ablation of T1a renal cell carcinoma. Patients and methods 15 patients were diagnosed as T1aN0M0 single renal cell carcinoma receiving percutaneous cool-tip radiofrequency ablation. Tumors located near to skin and were away from bowel and large vessels. Six tumors were located in the left kidney, and nine tumors in right. The average tumor diameter was 2.7±1.1 cm (1.1~3.9 cm). During the postoperative follow-up period, all patients received regular CT enhancement and ultrasound imaging. Results Percutaneous cool-tip radiofrequency ablation was successfully performed in 15 cases. No serious complications were observed. One month after operation, complete ablation was achieved in 13 cases and partial ablation in two cases, with a complete ablation rate of 86.7 % (13/15). Compared with preoperative values, there were no significant differences in Hb, ESR, SCr and GFR after operations (P>0.05). Three months after operation, 14 lesions were completely necrotic and only one lesion was partially necrotic. During the follow-up period of 2-22 months, all 15 cases were survival and no recurrence and metastasis was found. Conclusion Percutaneous cool-tip radiofrequency ablation is a safe, effective and minimally invasive treatment on T1a renal cell carcinoma.
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