微波消融治疗在小肾癌中的应用(附15例报告)

Microwave ablation in small renal tumor(15 cases report)

目的探讨微波消融治疗小肾癌的合理性、安全性、临床疗效。方法2005年7月至2008年12月,我们对15例小肾癌患者进行了微波消融治疗,术后病检均证实为肾细胞癌。其中男9例,女6例;中位年龄58.2岁。15例患者中2例为孤立肾,1例为双侧肾肿瘤,6例合并肾功能不全,2例合并肾病综合征,1例合并对侧肾结石,3例心脏功能及全身情况差。结果4例为开放微波消融,11例为腹腔镜下微波消融,平均接受1～3个点的微波消融(50W,每个点5～8min)。开放手术时间平均72min,腹腔镜手术时间平均65min,出血量均较少。2例患者术后出现漏尿,放置双J管1个月后无漏尿,其余患者无手术相关并发症。所有患者术后均行CT复查,均未见肿瘤残留,术后随访10～52个月均未见复发及转移。结论微波消融治疗小肾癌是一种安全性好、并发症少、近期疗效好的方法,是小肾癌治疗的一个合理的选择,但目前远期疗效仍需进一步观察。

Objective To evaluate the feasibility, safety and efficacy of microwave ablation in the treatment for small renal tumors. Methods From July 2005 to Dec 2008, 15 patients had received microwave ablation treatment in our center, all patients bad been confirmed by postoperative pathologic examination. The 15 patients （9 male and 6 female） have a mean age of 58.5 years. Of all 15 cases, 2 cases had a solitary kidney, 1 case had bilateral renal tumor, 6 cases of renal failure, 2 cases with nephrotic syndrome, 1 case with contralateral kidney stone. Results Four of 15 cases were subjected to open microwave ablation, the other 11 cases received laparoscopic microwave ablation. All patients received an average 1-3 points of microwave ablation （50 watts/5-8 minutes per point）. The total operation time was 72 rain in open ablation, and 65 rain in laparoscopic, all had little bleeding volume. Urine leakage had been noted in 2 cases after the treatment, and had been cured by the placement of DJ pipe in ureter for a month, there were no other complications. All patients had been followed up with CT scan 1 month after the procedure and no residual tumor noted. During the 10-52 months follow up, there were no recurrence and metastasis. Conclusions Microwave ablation is a safe and feasible therapy with excellent short-term efficacy and less complications, it is a reasonable choice for small renal tumor. However long-term efficacy needs further study.