Sacks Barry A, Sacks Ari C, Faintuch Salomao
Division of Interventional Radiology, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States.
Curr Opin Endocrinol Diabetes Obes. 2017 Jun;24(3):169-173. doi: 10.1097/MED.0000000000000329.
To review the current status of radiofrequency ablation as a primary treatment for hyperfunctioning adrenal nodules, predominantly aldosterone-producing adenomas (APAs).
Radiofrequency ablation is an established treatment for focal benign and malignant lesions, including metastatic disease to the adrenal gland. Hyperaldosteronism is the leading cause of secondary hypertension with up to 80% due to APA, statistically the most common functioning adrenal nodule. Although surgery remains the recommended treatment of choice for confirmed unilateral functioning adrenal nodules, radiofrequency ablation offers a less-invasive approach, with results comparable with surgery.
Radiofrequency ablation of functioning adrenal nodules is a newer application of a technology in use for almost 2 decades. Although limited, reports to date suggest that results are comparable with those of laparoscopic adrenalectomy, but with advantages including being a less-invasive outpatient procedure with lower morbidity, faster recovery, and lower cost. However, the current data are all retrospective, the number of patients treated is small, and reported long-term results are limited.
回顾射频消融作为高功能肾上腺结节(主要是醛固酮瘤,即APAs)主要治疗方法的现状。
射频消融是治疗局灶性良性和恶性病变(包括肾上腺转移瘤)的既定方法。原发性醛固酮增多症是继发性高血压的主要原因,高达80% 由醛固酮瘤引起,从统计学角度看,醛固酮瘤是最常见的功能性肾上腺结节。尽管手术仍是确诊的单侧功能性肾上腺结节的推荐首选治疗方法,但射频消融提供了一种侵入性较小的方法,其结果与手术相当。
功能性肾上腺结节的射频消融是一项已应用近20年的技术的新应用。尽管目前的报告有限,但迄今为止的数据表明,其结果与腹腔镜肾上腺切除术相当,但其优势包括是一种侵入性较小的门诊手术,发病率较低,恢复更快,成本更低。然而,目前所有数据均为回顾性的,接受治疗的患者数量较少,且报告的长期结果有限。