Rodriguez R, Chan D Y, Bishoff J T, Chen R B, Kavoussi L R, Choti M A, Marshall F F
James Buchanan Brady Urological Institute, Johns Hopkins Hospital and Johns Hopkins Bayview Hospital, Baltimore, Maryland 21287-2101, USA.
Urology. 2000 Jan;55(1):25-30. doi: 10.1016/s0090-4295(99)00394-5.
To present the preliminary results of renal ablative cryosurgery in selected patients.
Seven patients were treated, all of whom had small peripheral tumors and chose not to undergo partial or radical nephrectomy. Four patients underwent a rib-sparing flank incision; the remaining three underwent laparoscopy. All tumors were biopsied before cryoablation. Intraoperative ultrasound was used to monitor the cryolesion.
There were no intraoperative complications. The estimated blood loss averaged 111 mL. To date, 6 of the 7 patients have undergone at least one follow-up computed tomography scan (14.2 months average follow-up); all these scans demonstrated partial resolution of the lesion. Clinically, the patients tolerated the procedure without any renal complications or significant changes in creatinine.
This limited clinical trial has demonstrated the feasibility of treating small peripherally located renal tumors with cryosurgery with minimal morbidity and a favorable outcome. Further studies are necessary to determine the long-term efficacy of this treatment modality.
介绍在特定患者中进行肾消融冷冻手术的初步结果。
对7例患者进行了治疗，所有患者均患有外周小肿瘤且选择不接受部分或根治性肾切除术。4例患者采用保留肋骨的侧腹切口；其余3例接受腹腔镜手术。所有肿瘤在冷冻消融前均进行了活检。术中使用超声监测冷冻损伤。
无术中并发症。估计平均失血量为111毫升。迄今为止，7例患者中的6例已接受至少一次随访计算机断层扫描（平均随访14.2个月）；所有这些扫描均显示病变部分消退。临床上，患者耐受该手术，未出现任何肾脏并发症，肌酐也无显著变化。
这项有限的临床试验证明了用冷冻手术治疗外周小肾肿瘤的可行性，发病率极低且预后良好。有必要进行进一步研究以确定这种治疗方式的长期疗效。
