用于治疗肾癌的消融技术。
Ablative techniques for the management of kidney cancer.
作者信息
Hafron Jason, Kaouk Jihad H
机构信息
Glickman Urological Institute, Cleveland Clinic, Cleveland, OH 44195, USA.
出版信息
Nat Clin Pract Urol. 2007 May;4(5):261-9. doi: 10.1038/ncpuro0802.
For lesions smaller than 4 cm, nephron-sparing surgery has been shown to be oncologically equivalent to radical nephrectomy, albeit with the advantage of preservation of overall renal function. As such, partial nephrectomy became the first-line treatment option for localized, small renal masses. Minimally invasive options associated with limited morbidity--such as probe-ablative procedures--are, however, being investigated in selected patients for whom invasive, nephron-sparing surgery (whether laparoscopic or open) is undesirable. The main probe-ablative techniques being investigated as alternatives to partial nephrectomy are cryoablation, radiofrequency ablation, and high-intensity focused ultrasound. Advances in imaging, ablative system technologies, and early evidence that in situ tumor ablation can yield comparable results to those achieved with tumor resection in selected cases, have sparked significant interest in these minimally invasive techniques.
对于小于4厘米的病灶,保留肾单位手术已被证明在肿瘤学上等同于根治性肾切除术,尽管具有保留整体肾功能的优势。因此,部分肾切除术成为局限性小肾肿物的一线治疗选择。然而,对于那些不适合进行侵入性保留肾单位手术(无论是腹腔镜手术还是开放手术)的特定患者,正在研究与发病率有限相关的微创选择,如探针消融手术。作为部分肾切除术替代方法正在研究的主要探针消融技术有冷冻消融、射频消融和高强度聚焦超声。成像技术、消融系统技术的进步,以及早期证据表明在某些情况下原位肿瘤消融可产生与肿瘤切除相当的结果,引发了对这些微创技术的极大兴趣。