超声引导微波消融治疗T_(1a)期肾癌的初步临床研究

Initial clinical study of ultrasound guided percutaneous microwave ablation treatment for kidney tumors at T_(1a) stage

目的评价超声引导经皮微波消融治疗T_(1a)期肾癌的临床应用价值。方法回顾性研究解放军总医院2012年1月~2013年12月44例T_(1a)期肾癌患者共计48枚肿瘤的微波消融治疗资料,肿瘤最大径平均为(2.79±0.75)cm。记录并处理术后并发症和副作用。术后平均随访(18.1±9.3)个月,通过临床资料及影像检查评价疗效。结果 88.6%(39/44)的患者一次消融完成治疗,11.4%(5/44)的患者两次消融完成治疗。术后出现严重并发症结肠穿孔1例(2.3%),轻微并发症和副作用分别为7例(15.9%)和8例(18.2%)。97.7%(43/44)的患者消融治疗后无局部复发和远处转移表现。1例(2.3%)患者因肿瘤进展死亡。2例肾功能不全的患者在透析治疗辅助下安全有效完成了消融治疗。结论超声引导经皮微波消融治疗是T_(1a)期肾癌患者的一种安全、有效的微创治疗方法。

Objective To evaluate the value of percutaneous microwave ablation （MWA） treatment for kidney tumors at T1a stage under ultrasound （US） guidance. Methods From January 2012 to December 2013 in Chinese PLA General Hospital, the clinical data of 44 patients with 48 renal tumors proven histopathologically were retrospectively analyzed, whose tumors were performed the procedure of US-guided percutaneous MWA. The mean maximal diameter of the tumors was （2.79±0.75） cm, and the mean follow-up period was （18.1±9.3） months. The complications and side effects following the procedure were observed and treated, and the curative effects were assessment by clinical and image data during follow-up. Results Complete ablation of the whole tumors was achieved at one and two ablation in 88.6% （39/ 44） and 11.4% （5/44） patients, respectively. A case （2.3%） with major complication of colonic perforation, 7 cases （15.9%） with minor complications and 8 cases （18.2%） with side effects occurred after procedure. No local tumor recurrences and distal metastases were observed in 97.9% （43/44） patients. 1 case died due to tumoral progression. The ablation treatments of renal carcinomas in 2 patients with insufficient renal function were completed safely and effectively in the assistance of dialysis therapy. Conclusion US-guided percutaneous MWA will be a safely and effectively minimally-invasive technique in treating selected patients with kidney tumors at T1a stage.