Hsu T H, Fidler M E, Gill I S
Section of Laparoscopic and Minimally Invasive Surgery, Department of Urology, The Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Urology. 2000 Nov 1;56(5):872-5. doi: 10.1016/s0090-4295(00)00737-8.
To our knowledge, the chronic histopathologic effects of radiofrequency ablation (RFA) of renal parenchyma have not been extensively documented. In this study, we report the light and electron microscopic features of renal RFA in acute and chronic porcine models.
Eleven animals underwent renal RFA of the lower pole kidney bilaterally. RFA was performed laparoscopically in 6 acute animals and percutaneously in 5 chronic animals. Acute animals were killed immediately following surgery. One chronic animal each was killed on postoperative day 3, 7, 14, 30, and 90. Histopathologic evaluation of all renal tissue specimens was carried out with light and electron microscopy.
Acutely, the renal radiolesion appeared as a yellowish white, well-circumscribed, necrotic area on gross examination, with evidence of extensive coagulative necrosis and marked inflammation on microscopic examination. From day 1 through 90, light and electron microscopy revealed evidence of progressive, irreversible cell death and necrosis with diminishing inflammatory response in the glomeruli, tubules, and renal interstitium. RFA lesions underwent gradual spontaneous resorption of the necrotic area with ultimate autoamputation.
RFA results in necrosis of the ablated renal parenchyma.
据我们所知，肾实质射频消融（RFA）的慢性组织病理学效应尚未得到广泛记录。在本研究中，我们报告了急性和慢性猪模型中肾RFA的光镜和电镜特征。
11只动物双侧肾下极接受RFA。6只急性动物通过腹腔镜进行RFA，5只慢性动物通过经皮进行RFA。急性动物术后立即处死。分别在术后第3、7、14、30和90天处死1只慢性动物。对所有肾组织标本进行光镜和电镜组织病理学评估。
急性时，肾放射性损伤在大体检查时表现为黄白色、边界清楚的坏死区，镜检可见广泛的凝固性坏死和明显炎症。从第1天到90天，光镜和电镜显示肾小球、肾小管和肾间质中存在进行性、不可逆的细胞死亡和坏死，炎症反应逐渐减轻。RFA损伤坏死区逐渐自发吸收，最终自行脱落。
RFA导致被消融的肾实质坏死。
