Campagnacci R, Guerrieri M, De Sanctis A, Sarnari J, Lezoche E
Clinica di Chirurgia Generale e Metodologia Chirurgica, Ospedali Riuniti, Ancona, Italy.
J Endourol. 2006 May;20(5):321-5. doi: 10.1089/end.2006.20.321.
To report our experience with in situ laparoscopic radiofrequency ablation (RFA) of renal tumors.
From September 2000 to May 2002, two men, 81 and 71 years old, and one woman, 75 years old, were referred to our department for right renal clear-cell carcinoma <3.5-cm diameter. The 71- year-old patient had only one kidney. Because of the tumor location, the percutaneous route was not considered the approach of choice. Moreover, a simultaneous large right adrenal incidentaloma (myelolipoma) and a right colon cancer were known to be present in the second and third patient, respectively. The aforementioned findings suggested the laparoscopic route as a preferable technique to treat both the renal and the other morbidities.
Under laparoscopic ultrasonography control of tine placement, a 20-minute thermoablation cycle at 100 degrees C mean temperature was performed. Including right colectomy and right adrenalectomy, the operative time was 120, 200, and 275 minutes, with postoperative hospital stays of 3, 4, and 6 days for the three patients, respectively. Abdominal CT scans after 1 and 4 weeks and then every 6 months confirmed complete treatment of the lesion at 44 months' average follow-up (range 36-56 months).
When percutaneous access is not feasible or the patient should undergo another laparoscopic procedure simultaneously, laparoscopic RFA of renal tumors is feasible and effective, as shown by long-term follow-up.
报告我们对肾肿瘤进行腹腔镜原位射频消融（RFA）的经验。
2000年9月至2002年5月，两名男性患者，年龄分别为81岁和71岁，以及一名75岁女性患者，因直径<3.5 cm的右肾透明细胞癌转诊至我科。71岁的患者仅有一个肾脏。由于肿瘤位置的原因，经皮途径不被视为首选方法。此外，已知第二例和第三例患者分别同时存在较大的右肾上腺偶发瘤（髓样脂肪瘤）和右结肠癌。上述情况表明，腹腔镜途径是治疗肾脏疾病及其他病变的优选技术。
在腹腔镜超声引导针穿刺位置的控制下，进行了平均温度为100摄氏度、持续20分钟的热消融周期。包括右半结肠切除术和右肾上腺切除术，三名患者的手术时间分别为120分钟、200分钟和275分钟，术后住院时间分别为3天、4天和6天。1周和4周后以及随后每6个月进行的腹部CT扫描证实，在平均44个月（范围36 - 56个月）的随访中病变得到了完全治疗。
当经皮途径不可行或患者需要同时进行另一种腹腔镜手术时，如长期随访所示，腹腔镜肾肿瘤RFA是可行且有效的。
