Gu Yang-kui, Huang Jin-hua, Gao Fei, Li Wen-quan, Fan Wei-jun, Zhang Liang
Department of Imaging and Interventional Radiology, State Key Laboratory of Oncology in Southern China, Department of Medical Imaging & Interventional Radiology, Cancer Center, Sun Yat-sen University, Guangzhou 510060, China.
Zhonghua Yi Xue Za Zhi. 2009 Jul 21;89(27):1907-12.
To probe clinical value of percutaneous ethanol ablation (PEA) in complicated renal carcinoma.
10 cases complicated renal carcinoma patients with 16 lesions ranged from 1.7-8.4 cm totally, renal cancer in 7 cases, renal hamartoma in 3 cases,underwent CT guided percutaneous ethanol ablation (PEA) by local anesthesia Plain and contrast CT scan was adopted to evaluate clinical effect and make follow-up.
Each patient accepted 2 times PEA in average with follow-up time ranged from 2 to 26 months averaged in 18 months. No recurrence was seen in 1 case isolated renal patient unfortunately with renal cancer through 1 year and 9 months follow-up after 2 times PEA. The other isolated renal cancer patient died of acute renal failure after 4 times PEA. Lesions were fully ablated in 2 cases renal cancer patients with low back pain and blood urine and symptoms disappeared after PEA accordingly. Other 3 cases renal cancer patients went through 1 year and 6 months, 2 years and 2 months, and 1 year follow-up respectively. 1 case died of distant metastasis and 2 cases kept stabilization evaluated by CT scan. Hemorrhage within lesions disappeared in 2 cases renal hamartoma after just one time PEA, which kept stabilization through 1 year, 1 year and 10 months follow-up respectively. 1 case hamartoma patient gave up treatment after 2 times PEA. No complications including urinary fistula, hemorrhage, intestinal perforation and needle track implantation were seen in all patients.
CT guided PEA is a microinvasive, positive curative effect and facultative method in treating complicated renal carcinomas. But for isolated renal patient with renal cancer,PEA should be performed cautiously.
探讨经皮乙醇消融术（PEA）在复杂性肾癌中的临床价值。
10例复杂性肾癌患者共16个病灶，直径1.7 - 8.4 cm，其中肾癌7例，肾错构瘤3例，在局部麻醉下接受CT引导下经皮乙醇消融术（PEA）。采用平扫及增强CT扫描评估临床疗效并进行随访。
每位患者平均接受2次PEA，随访时间2至26个月，平均18个月。1例孤立肾肾癌患者经2次PEA后随访1年9个月未见复发；另1例孤立肾肾癌患者经4次PEA后死于急性肾衰竭。2例肾癌患者伴有腰痛及血尿，病灶完全消融，PEA后症状消失。其他3例肾癌患者分别随访1年6个月、2年2个月和1年，1例死于远处转移，2例经CT扫描评估病情稳定。2例肾错构瘤患者经1次PEA后病灶内出血消失，分别随访1年、1年10个月病情稳定。1例错构瘤患者经2次PEA后放弃治疗。所有患者均未出现尿瘘、出血、肠穿孔及针道种植等并发症。
CT引导下PEA是治疗复杂性肾癌的一种微创、疗效肯定且可选择的方法。但对于孤立肾肾癌患者，行PEA时应谨慎。
