Wen C Charles, Nakada Stephen Y
Division of Urology, Department of Surgery, University of Wisconsin-Madison Medical School, Madison, Wisconsin 53792, USA.
Curr Opin Urol. 2006 Sep;16(5):321-6. doi: 10.1097/01.mou.0000240302.11379.5b.
The success of partial nephrectomy for the treatment of small renal cancers has led to the development of energy ablative technologies, which are less invasive alternatives for performing nephron-sparing surgery. Currently, cryoablation and radiofrequency ablation are the two most reported technologies. Both technologies use very different means to cause cellular injury. Additionally, three newer technologies, high-frequency ultrasound ablation, laser interstitial therapy, and microwave therapy are emerging in the literature.
Three- and 4-year data for cryoablation and radiofrequency ablation are now becoming available. On the basis of these studies, it is clear that ablative technologies can be effective treatments for select small renal tumors. It is also evident that both percutaneous and laparoscopic approaches offer minimal morbidity.
As long-term (5 years and greater) outcome data for ablative technologies accumulate, we are likely to see an increase in clinical reports, including more patients who may be candidates for extirpative surgery. Technology will advance, leading to smaller probes with larger treatment zones, making it possible to treat larger tumors and potentially even tumors in the advanced disease state.
部分肾切除术治疗小肾癌的成功促使了能量消融技术的发展，这是进行保留肾单位手术的侵入性较小的替代方法。目前，冷冻消融和射频消融是报道最多的两种技术。这两种技术通过截然不同的方式造成细胞损伤。此外，高频超声消融、激光间质治疗和微波治疗这三种较新的技术也在文献中出现。
冷冻消融和射频消融的3年及4年数据现已可得。基于这些研究，很明显消融技术对于特定的小肾肿瘤可以是有效的治疗方法。同样明显的是，经皮和腹腔镜方法的发病率都很低。
随着消融技术长期（5年及以上）结果数据的积累，我们可能会看到临床报告增多，包括更多可能适合进行切除手术的患者。技术将会进步，导致探头更小而治疗区域更大，从而有可能治疗更大的肿瘤，甚至可能治疗处于疾病晚期的肿瘤。
