Drum Tower Hospital of Nanjing University Medical School, Department of Urology, Nanjing, China.
Urology. 2011 Apr;77(4):798-802. doi: 10.1016/j.urology.2010.10.014. Epub 2011 Jan 22.
To report our experience of laparoscopic radiofrequency ablation (RFA) on patients with renal tumors. RFA has been increasingly applied in the management of small renal tumors. However, it was performed mostly via percutaneous approach, with limited cases and a short follow-up period.
From February 2006 to March 2008, laparoscopic RFA was performed on 106 renal tumors (size range: 0.9-5.5 cm) in 106 selected patients (74 men and 32 women, age range: 25-81 years). Initial contrast-enhanced computed tomography (CT) examination was performed seven days after the procedure, with subsequent CT assessment at three months, six months, and every six months thereafter. Serum creatinine measurement was conducted along with each time CT examination.
The mean follow-up period was 32 months (range: 12-48). All 106 tumors were biopsied before RFA, of which 90 were diagnosed as renal cell carcinoma (RCC) (84.90%). There was one incomplete ablation. One case with radiographic local recurrence was then proved by pathologic analysis of the nephrectomy specimen to have no cancer cells. The local tumor control rate was 98.1% (104/106). Of the 90 RCC cases, the disease-free survival rate was 97.8% (88/90); both the cancer-specific and the overall survival rate were 100%. No death or renal failure after the procedure has yet been found.
Our results showed that the laparoscopic RFA on small renal mass was safe, with outcomes of patients comparable with those by partial nephrectomy and percutaneous RFA. Further research and a longer follow-up period are needed to confirm our results.
报告我们在肾肿瘤患者中应用腹腔镜射频消融（RFA）的经验。RFA 已越来越多地应用于小肾肿瘤的治疗。然而，它主要通过经皮途径进行，病例数有限且随访时间较短。
2006 年 2 月至 2008 年 3 月，对 106 例（74 例男性，32 例女性；年龄 25-81 岁）选择的患者的 106 个肾肿瘤（大小范围：0.9-5.5cm）进行了腹腔镜 RFA。术后 7 天行初次增强 CT 检查，之后每 3、6 个月及此后每 6 个月进行 CT 评估。每次 CT 检查时同时检测血清肌酐。
平均随访时间为 32 个月（范围：12-48 个月）。所有 106 个肿瘤均在 RFA 前进行了活检，其中 90 个诊断为肾细胞癌（RCC）（84.90%）。有 1 例不完全消融。随后，通过对肾切除标本的病理分析，发现 1 例影像学局部复发的病例无癌细胞，证实局部肿瘤控制率为 98.1%（104/106）。90 例 RCC 病例中，无病生存率为 97.8%（88/90）；癌症特异性生存率和总体生存率均为 100%。术后无死亡或肾功能衰竭。
我们的结果表明，腹腔镜下小肾肿瘤 RFA 是安全的，其患者的结果与部分肾切除术和经皮 RFA 相当。需要进一步研究和更长的随访时间来证实我们的结果。
