超声引导下经皮微波消融能有效治疗肾细胞癌

Ultrasound Guided Percutaneous Microwave Ablation can Effectively Treat Renal Cell Carcinoma

为探讨超声引导下经皮微波消融术治疗肾细胞癌的效果,本研究回顾性分析超声引导下经皮微波消融术(microwave ablation, MWA)治疗肾细胞癌的并发症。本研究共选取100例肿瘤患者,均接受超声引导下经皮微波消融术治疗,随访1个月、3个月、6个月,每6个月进行造影增强超声、计算机断层扫描或磁共振成像。本研究发现109个肿瘤中有94个(86.2%)手术获得成功,中位随访时间为25 (1.43～92.52)个月。在109例肿瘤中,发现35例并发症,并发症发生率为32.1%。27.5%的手术发生轻微并发症(Clavien-DindoⅠ和Ⅱ级),严重并发症(Clavien-DindoⅢ级)发生率为4.6%,分别占总并发症的85.7%和14.3%。所有的轻微并发症患者均治愈。3例患者发生胸腔积液,2例发生肠道损伤。3例患有胸腔积液的患者有肝硬化病史,微波消融后通过导管引流进行治疗,肠道损伤患者行手术治疗。在所有患者中,手术前后血清肌酐和尿素氮水平无显著差异。超声引导下的经皮微波消融治疗肾细胞癌是一种有效的治疗方法,然而,如果肾肿瘤靠近肠道,或病人有严重的并发症或接受了腹部手术,则必须更慎重地进行手术。

To investigate the effect of ultrasound-guided percutaneous microwave ablation on renal cell carcinoma,this study retrospectively analyze d the complications of renal cell carcinoma treated by ultrasound-guided microwave ablation(MWA).A total of 100 patients selected with tumors underwent ultrasound-guided percutaneous microwave ablation.The patients were followed up at 1 st month,3 nd month,and 6 th month,and every 6 months,they underwent contrast-enhanced ultrasound,computed tomography,or magnetic resonance imaging.This study found that 94(86.2%)of 109 tumors were successfully operated.The median follow-up time was 25(1.43~92.52)months.In the 109 tumors,35 were found to have complications with a complication rate of 32.1%.27.5%had mild complications(Clavien-DindoⅠandⅡ)and severe complications(Clavien-DindoⅢ)was 4.6%,accounting for 85.7%and 14.3%of the total complications,respectively.All mild complications were cured.There were 3 cases of pleural effusion and 2 cases of intestinal injury occurred.Three patients with pleural effusion had a history of cirrhosis and were treated by catheter drainage after microwave ablation.The patients with intestinal injury were treated with surgical treatment.In all patients,there was no significant difference in serum creatinine and urea nitrogen levels before and after surgery.Ultrasound-guided percutaneous microwave ablation for renal cell carcinoma might be an effective treatment,however,if the kidney neoplasm is close to the intestine,or if the patient has severe complications or has undergone abdominal surgery,surgery must be performed more carefully.