Johnson D Brooke, Solomon Stephen B, Su Li-Ming, Matsumoto Edward D, Kavoussi Louis R, Nakada Stephen Y, Moon Timothy D, Shingleton W Bruce, Cadeddu Jeffrey A
Division of Urology, University of Utah Health Sciences Center, Salt Lake City, Utah, USA.
J Urol. 2004 Sep;172(3):874-7. doi: 10.1097/01.ju.0000135833.67906.ec.
Ablative treatments (cryoablation or radio frequency ablation) for renal cell carcinoma aim to decrease morbidity by treating renal tumors in situ, eliminating the need for extirpation. These technologies have potential for complications previously unassociated with renal tumor treatment. We identified complications associated with percutaneous and laparoscopic ablative treatment of renal tumors.
Groups at medical centers with reported experience with ablation of renal tumors were invited to participate in this study. Each group submitted retrospective data regarding overall ablative treatment experience and associated complications. For each incident the nature of the complication, its associated morbidity, the necessity and nature of any subsequent interventions, and the final patient outcome were evaluated. Complications were divided into minor and major categories. Data were collected from groups at 4 institutions with a combined experience of 271 cases. Of these cases 139 were cryoablation and 133 were radio frequency ablation. There were 181 procedures performed percutaneously and 90 performed laparoscopically.
A total of 30 complications occurred (11.1%) with 5 major (1.8%) and 25 minor (9.2%) complications, and 1 death (0.4%). Overall 26 of the 30 complications (86.7%) were directly attributable to the ablation procedure. The most common complication was pain or paraesthesia at the probe insertion site.
Ablation technologies appear to have a low complication profile when used to treat small renal tumors. The majority of complications are minor and require observation only. Further study and followup are necessary to determine long-term oncological efficacy.
肾细胞癌的消融治疗（冷冻消融或射频消融）旨在通过原位治疗肾肿瘤来降低发病率，从而无需进行切除手术。这些技术可能会引发一些以前与肾肿瘤治疗无关的并发症。我们确定了与经皮和腹腔镜肾肿瘤消融治疗相关的并发症。
邀请有肾肿瘤消融治疗经验报告的医疗中心的团队参与本研究。每个团队提交有关总体消融治疗经验及相关并发症的回顾性数据。对于每一例事件，评估并发症的性质、其相关的发病率、任何后续干预措施的必要性和性质以及最终的患者结局。并发症分为轻微和严重两类。数据收集自4家机构的团队，其综合经验涵盖271例病例。其中139例为冷冻消融，133例为射频消融。经皮操作181例，腹腔镜操作90例。
共发生30例并发症（11.1%），其中严重并发症5例（1.8%），轻微并发症25例（9.2%），死亡1例（0.4%）。总体而言，30例并发症中有26例（86.7%）直接归因于消融手术。最常见的并发症是探头插入部位的疼痛或感觉异常。
消融技术用于治疗小肾肿瘤时似乎并发症发生率较低。大多数并发症为轻微并发症，仅需观察。需要进一步研究和随访以确定长期肿瘤学疗效。
