局麻下经皮冷冻消融治疗肾肿瘤的初步报告

Percutaneous cryoablation under local anesthesia for renal tumors:a preliminary report

目的探讨局麻下经皮冷冻消融治疗肾肿瘤的近期临床疗效。方法 对6例肾肿瘤患者(共6个肿瘤)行局麻下经皮冷冻消融治疗。均经CT或MRI检查证实:肿瘤位于左肾3例,右肾3例;肾上极1例,中极3例,下极2例;肿瘤直径平均2.9(1.4～4.8)cm,远离集合系统,无远处转移。临床分期均为T1aN0M0。术中常规行穿刺病理检查。结果 6例患者手术均成功,平均手术时间(68±21)min。未出现严重并发症。穿刺病理检查,6个肿瘤中,透明细胞癌4个,乳头状肾细胞癌1个,血管平滑肌脂肪瘤1个。无局部复发或远处转移病例。结论 局麻下经皮冷冻消融治疗肾肿瘤安全有效,远期疗效尚需进一步随访观察。

Objective To present the technique and short-term results of percutaneous renal cryoablation under local anesthesia for renal tumors. Methods Six selected patients cases with six renal tumors were included in present study. There were 3 cases of left renal tumor,3 cases of right renal tumor. Tumors were located at the upper pole （ 1 case） , middle （3 cases ） , or lower pole （ 2 cases ）. A11 tumors were located distant from the collecting system, without evidence of metastatic disease. Mean tumor size was 2.9 （ range ： 1.4-4.8 ） cm. All patients were taken routine biopsy. Results Cryoabiation was technically successful in all 6 patients（6 tmnors）. The mean time of the operations was（68 ± 21 ）min. No severe operative complication was observed. The biopsy results revealed that 4 tumors were renal clear cell carcinomas, and 1 tumor was papillary renal cell carcinomas, and I tumor was renal angiomyolipoma. No evidence of local or port-site recurrence was found, and no metastatic disease. Conclusions Percutaneous renal cryoablation under local anesthesia for renal tumors could be an ac- curate and effective intervention with a relatively low incidence of complications. Critical long-term data regarding percutaneons renal cryoablation under local anesthesia are awaited.