Munver Ravi, Threatt Chris B, Delvecchio Fernando C, Preminger Glenn M, Polascik Thomas J
Division of Urology, Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.
Urology. 2002 Jul;60(1):170-5. doi: 10.1016/s0090-4295(02)01667-9.
The increased incidental detection of small (less than 4 cm) renal tumors has stimulated investigations of minimally invasive therapies. Radiofrequency energy is a relatively new and evolving technology that has been used for a variety of experimental and clinical applications. We evaluate the efficacy of hypertonic interstitial saline-augmented radiofrequency therapy to ablate a malignant VX-2 tumor implanted in a rabbit kidney, as measured by the completeness of tumor destruction and progression to metastasis.
The VX-2 tumor was surgically implanted into the left lower pole parenchyma of 18 New Zealand white rabbit kidneys. Ten days after implantation, hypertonic interstitial saline-augmented radiofrequency ablation was performed (n = 12) using a radiofrequency therapy system (RFT, United States Surgical Corp.). A sham operation was performed on a control group (n = 6). Animals were humanely killed at 5, 10, and 15-day intervals, and the clinical response and effect of radiofrequency energy on the malignant renal tissue was assessed.
No postoperative complications were encountered. The mean size of the implanted VX-2 tumor was 1.87 cm2. Kidneys in the treated group exhibited marked destruction of tumor tissue. Histologic analysis revealed coagulative necrosis of both malignant and normal renal tissue in the treated group. Three rabbits (1 control, 2 treated) died of metastatic disease.
Coagulative necrosis of renal parenchyma and tumor tissue was clearly demonstrated after radiofrequency ablation using the RFT system. The aggressive growth pattern of the VX-2 tumor often resulted in progression to metastatic disease while precluding complete tumor ablation. Hypertonic saline-augmented radiofrequency ablation is a promising new technology for the management of small, locally confined, renal tumors and has the potential for use with a minimally invasive approach.
小（小于4厘米）肾肿瘤偶然发现率的增加促使了对微创治疗的研究。射频能量是一种相对较新且不断发展的技术，已用于各种实验和临床应用。我们评估高渗性间质盐水增强射频治疗对植入兔肾的恶性VX - 2肿瘤的消融效果，通过肿瘤破坏的完整性和转移进展来衡量。
将VX - 2肿瘤手术植入18只新西兰白兔左肾下极实质。植入后10天，使用射频治疗系统（RFT，美国外科公司）进行高渗性间质盐水增强射频消融（n = 12）。对对照组（n = 6）进行假手术。在间隔5天、10天和15天时对动物实施安乐死，并评估临床反应和射频能量对恶性肾组织的影响。
未遇到术后并发症。植入的VX - 2肿瘤平均大小为1.87平方厘米。治疗组的肾脏显示出肿瘤组织的明显破坏。组织学分析显示治疗组恶性和正常肾组织均发生凝固性坏死。3只兔子（1只对照，2只治疗）死于转移性疾病。
使用RFT系统进行射频消融后，肾实质和肿瘤组织的凝固性坏死得到了明确证实。VX - 2肿瘤的侵袭性生长模式常常导致进展为转移性疾病，同时无法实现肿瘤的完全消融。高渗盐水增强射频消融是一种用于治疗小的、局部局限的肾肿瘤的有前景的新技术，并且有潜力用于微创方法。
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