Zhang Dakun, Dong Baowei, Wang Yang, Liu Liping, Zhang Xinli, Yu Xiaoling, Liang Ping, Gao Yongyan
Department of Ultrasound, Chinese People's Liberation Army 302 Hospital, Beijing, China.
J Urol. 2009 Oct;182(4):1588-93. doi: 10.1016/j.juro.2009.06.004. Epub 2009 Aug 15.
We compared the effectiveness of percutaneous microwave ablation and radical nephrectomy for implanted VX-2 carcinoma in rabbit kidneys.
VX-2 tumors were surgically implanted into the left lower pole parenchyma of 26 New Zealand White rabbit kidneys. At 12 days after implantation implanted rabbits were randomly assigned to 1 of 3 groups according to therapy type, including percutaneous microwave ablation, nephrectomy and no treatment. The anticancer effect and safety were compared among the groups. Histopathological changes in tumor tissue with time after microwave ablation were evaluated.
The survival rate in the percutaneous microwave ablation group was significantly higher than that in the no treatment group and showed no statistically significant difference compared with that in the nephrectomy group. Serum creatinine did not increase after microwave therapy but we noted a statistically significant serum creatinine increase in the nephrectomy group. Histological analysis revealed completely coagulative necrosis of the tumor in 10 of 12 rabbits (83.3%) after microwave ablation. Two rabbits died, including 1 of peritonitis in the nephrectomy group and 1 of intestinal fistula due to heat injury in the percutaneous microwave ablation group.
This study shows that percutaneous microwave ablation can achieve effects similar to those of radical nephrectomy. It caused no significant changes in renal function when treating implanted VX-2 renal tumors. Percutaneous microwave ablation has the potential of being a minimally invasive treatment for small renal tumors.
我们比较了经皮微波消融术和根治性肾切除术对兔肾植入VX-2癌的疗效。
将VX-2肿瘤手术植入26只新西兰白兔左肾下极实质。植入后12天,根据治疗类型将植入兔随机分为3组中的1组,包括经皮微波消融、肾切除术和不治疗。比较各组的抗癌效果和安全性。评估微波消融后肿瘤组织随时间的组织病理学变化。
经皮微波消融组的生存率显著高于不治疗组,与肾切除术组相比无统计学显著差异。微波治疗后血清肌酐未升高,但我们注意到肾切除术组血清肌酐有统计学显著升高。组织学分析显示,微波消融后12只兔中有10只(83.3%)肿瘤完全凝固性坏死。2只兔死亡,包括肾切除术组1只死于腹膜炎,经皮微波消融组1只死于热损伤导致的肠瘘。
本研究表明,经皮微波消融可达到与根治性肾切除术相似的效果。治疗植入的VX-2肾肿瘤时,其对肾功能无显著影响。经皮微波消融有潜力成为小肾肿瘤的微创治疗方法。