Mahnken Andreas H, Günther Rolf W, Tacke Josef
Department of Diagnostic Radiology, University Hospital, Aachen University of Technology, Pauwelsstrasse 30, 52074 Aachen, Germany.
Eur Radiol. 2004 Aug;14(8):1449-55. doi: 10.1007/s00330-004-2360-y. Epub 2004 May 19.
Percutaneous thermal ablation is increasingly applied in the therapy of renal tumors. Various techniques are available, allowing a safe and accurate therapy of renal tumors either using hyperthermia such as radiofrequency ablation (RFA), laser-induced thermotherapy (LITT) and microwave ablation (MW) or by hypothermia (cryoablation). As thermal ablation is a minimally invasive and nephron-sparing procedure, it is ideally suited for patients with a single kidney, multiple tumors or contraindications for resective surgery. Although cryotherapy is the most extensively studied technique, RFA has become the most accepted thermal ablation technique over the last years. Modern RFA probes allow ablation volumes between 2 and 5 cm in diameter. A major advantage of RFA is the ability to avoid tract bleeding and tumor seeding by coagulating the puncture channel during RF probe withdrawal. The increasing number of clinical reports on RFA of the kidney show the promising potential of renal RFA for minimally invasive tumor treatment. Due to its technical benefits, RFA seems to be advantageous when compared to cryoablation or laser ablation. However, there are no long-term follow-up or comparative data proving an equal effectiveness to surgery.
经皮热消融在肾肿瘤治疗中的应用日益广泛。现有多种技术,可通过高温(如射频消融(RFA)、激光诱导热疗(LITT)和微波消融(MW))或低温(冷冻消融)对肾肿瘤进行安全、准确的治疗。由于热消融是一种微创且保留肾单位的手术,非常适合单肾、多发肿瘤或有手术切除禁忌证的患者。尽管冷冻疗法是研究最广泛的技术,但在过去几年中,RFA已成为最被认可的热消融技术。现代RFA探头可实现直径2至5厘米的消融体积。RFA的一个主要优点是在拔出射频探头时能够通过凝固穿刺通道避免穿刺道出血和肿瘤种植。越来越多关于肾脏RFA的临床报告显示了肾RFA在微创肿瘤治疗方面的广阔前景。由于其技术优势,与冷冻消融或激光消融相比,RFA似乎更具优势。然而,目前尚无长期随访或比较数据证明其与手术具有同等疗效。