摘要
目的探讨腹腔镜下冷循环射频消融治疗肾细胞癌的可行性。方法对12例肾癌患者选择性实施腹腔镜下冷循环射频消融治疗13次。肿瘤位于左肾4例，右肾7例，双肾1例。肿瘤最大径2．1～8．5cm，其中T1N0M0 11例，T2N0M0 2例。术后采用CT、超声造影定期随访。结果平均手术时间（92±24）min，平均出血量（50±2）ml，术中均未输血。未见腹腔镜手术相关并发症。术后6周13个肾癌病灶，完全消融12个、消融不全1个，完全消融率92．3％（12／13）。血红蛋白、红细胞沉降率、血肌酐、患侧肾小球滤过率较术前无明显变化（P〉0．05）。术后3个月10例患者复查CT，病灶完全坏死9例、部分坏死1例。随访时间1～16个月，中位数7．8个月，12例均生存。无局部及远处复发病例。结论腹腔镜下冷循环射频消融是一种安全有效治疗肾癌的新方法，比超声引导下射频治疗定位更加精确，可以应用于不适合超声引导下经皮肾穿刺射频消融的病例。
Objective To evaluate the clinical feasibility of laparoscopic cool-tip radiofrequency ablation （LCRFA）for renal cell carcinoma. Methods Twelve selected cases of primary renal cell carcinoma underwent LCRFA. Of them, 4 cases of left renal carcinomas, 7 cases had right renal carcinomas and 1 case had bilateral renal carcinomas. The maximum diameter of the tumors was 2.1--8.5 cm. Eleven cases were T1N0M0 and the other one was T2 N0M0. Results The mean operation time was 92±24 min, and the mean blood loss was 50±29 ml. None of the cases need blood transfusion post-operation. No laparoseopic operative complications were observed. Six weeks after operation, complete ablation was achieved in 12 lesions and partial ablation in 1, with a complete ablation rate of 92.3 %（12/13）. There was no statistic change of H b, ESR,SCr and GFR after operations（P〉0.05）. Ten cases underwent CT examination 3 months after the treatment ,9 cases showed complete necrosis of tumor,1 case showed partial necrosis. No recurrence was found. All of the 12 cases remained survived during the follow-up for 1 -16 months（median,7.8 months）. Conclusions LCRFA for renal cell carcinoma is an accurate and effective intervention with a low incidence of complications, and is more accurate than ultrasound guided percutaneous radiofrequency ablation.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2008年第9期592-594,共3页
Chinese Journal of Urology
基金
江苏省六大人才高峰基金资助项目（B类）
关键词
冷循环电极
射频
腹腔镜
肾肿瘤
Cool tipped electrodes
Radiofrequency
Laparoscopes
Kidney neoplasms
