Narayanan Govindarajan, Doshi Mehul H
Department of Radiology, Division of Vascular Interventional Radiology, University of Miami Miller School of Medicine, 1475 NW 12th Avenue Grd Fl. C-085, 33136, Miami, FL, USA.
Department of Radiology, Division of Vascular Interventional Radiology, University of Miami Miller School of Medicine, 1475 NW 12th Avenue Grd Fl. C-080, 33136, Miami, FL, USA.
Curr Urol Rep. 2016 Feb;17(2):15. doi: 10.1007/s11934-015-0571-1.
Small renal masses (SRMs) have been traditionally managed with surgical resection. Minimally invasive nephron-sparing treatment methods are preferred to avoid harmful consequences of renal insufficiency, with partial nephrectomy (PN) considered the gold standard. With increase in the incidence of the SRMs and evolution of ablative technologies, percutaneous ablation is now considered a viable treatment alternative to surgical resection with comparable oncologic outcomes and better nephron-sparing property. Traditional thermal ablative techniques suffer from unique set of challenges in treating tumors near vessels or critical structures. Irreversible electroporation (IRE), with its non-thermal nature and connective tissue-sparing properties, has shown utility where traditional ablative techniques face challenges. This review presents the role of IRE in renal tumors based on the most relevant published literature on the IRE technology, animal studies, and human experience.
传统上，小肾肿块（SRMs）的治疗方法是手术切除。为避免肾功能不全的有害后果，微创保肾治疗方法更受青睐，其中部分肾切除术（PN）被视为金标准。随着SRMs发病率的上升和消融技术的发展，经皮消融现在被认为是一种可行的手术切除替代治疗方法，其肿瘤学结局相当，且具有更好的保肾特性。传统的热消融技术在治疗血管或关键结构附近的肿瘤时面临一系列独特的挑战。不可逆电穿孔（IRE）具有非热性质和保留结缔组织的特性，在传统消融技术面临挑战的情况下显示出应用价值。本综述基于关于IRE技术、动物研究和人类经验的最相关已发表文献，阐述了IRE在肾肿瘤中的作用。
