超声引导下经皮微波消融治疗恶性胸、腹壁肿瘤

Ultrasound-guided percutaneous microwave ablation for malignant thoracic or abdominal wall tumors

目的观察超声引导下经皮微波消融(MWA)治疗恶性胸、腹壁肿瘤的效果。方法对11例恶性胸、腹壁肿瘤患者行超声引导下经皮MWA治疗,共治疗14个病灶,腹壁6个,胸壁8个;术后随访,观察治疗效果及不良反应。结果11例超声引导下MWA治疗均成功,技术成功率100%。术后1个月8例治疗有效,3例肿瘤残存。2例术后出现局部疼痛,经对症治疗后缓解;1例局部脂肪液化,予局部消毒换药1个月后痊愈。未见气胸、肠道损伤、皮肤烧伤等严重并发症。4例术前合并病灶周围神经痛,术后疼痛得到有效控制。术后随访4~28个月,中位随访时间8个月;期间2例失访、2例死亡;至随访终点7例疗效较好,未见复发及转移。结论超声引导下经皮MWA治疗恶性胸、腹壁肿瘤安全、有效。

Objective To observe the effect of ultrasound-guided percutaneous microwave ablation(MWA)for treatment of malignant thoracic and abdominal wall tumors.Methods Ultrasound-guided percutaneous MWA was performed in 11 patients with malignant thoracic or abdominal wall tumors.There were a total of 14 tumors,6 at the abdominal wall and 8 at the chest wall.Postoperative follow-up was performed to observe the therapeutic effect and adverse reactions.Results All 11 patients were successfully treated with ultrasound-guided MWA,and the technical success rate was 100%.One month after ablation,effective treatment was observed in 8 cases,while remained tumors were found in the rest 3 cases.Local pain after ablation occurred in 2 patients,which relieved after symptomatic treatments.Local fat liquefaction occurred in 1 patient,which was healed after local disinfection and dressing change for 1 month.No severe complications such as pneumothorax,intestinal injury and skin burn occurred.The pains were effectively controlled in 4 patients with peripheral neuropathic pains.The patients were followed up for 4-28 months,with a median follow-up time of 8 months,during which 2 cases were lost to follow-up and 2 cases died.At the end of follow-up,good effect was observed in the remaining 7 patients,while no recurrence or metastasis was found.Conclusion Ultrasound-guided MWA was safe and effective for local treatment of malignant thoracic or abdominal wall tumors.