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肾血管平滑肌脂肪瘤的冷冻消融:安全性和有效性评估

Cryoablation of Renal Angiomyolipoma: An Evaluation of Safety and Efficacy.

作者信息

Makki Ahmad, Graumann Ole, Høyer Søren, Solvig Jan, Østraat Øyvind, Madsen Mia Gebauer, Nielsen Tommy Kjærgaard

机构信息

1 Department of Urology, Aarhus University Hospital , Aarhus, Denmark .

2 Department of Radiology, Odense University Hospital , Odense, Denmark .

出版信息

J Endourol. 2017 Nov;31(11):1117-1122. doi: 10.1089/end.2017.0376. Epub 2017 Sep 28.

Abstract

BACKGROUND

Small series have reported that cryoablation (CA) is a safe and feasible minimally invasive nephron-sparing alternative for the treatment of renal angiomyolipomas (renal AMLs). The aim of the present study was to investigate the safety and efficacy of CA in patients with renal AML.

MATERIALS AND METHODS

A retrospective review of 19 renal AML lesions treated with CA at Aarhus University Hospital, Denmark, over a 5-year period.

RESULTS

The treatment was performed as laparoscopy-assisted CA on 7 lesions, and in the remaining 12 lesions CA was performed as a percutaneous ultrasound-guided CA. The mean patient age was 46 years [interquartile range (IQR) 30] and the mean tumor volume was 50.1 cm (IQR 53.3). In all cases, the procedure was effectively conducted with no conversion to open surgery, and no major complications were experienced. The mean follow-up time was 25 months (IQR 13). Mean maximum tumor volume was reduced from 50.1 cm (IQR 53.3) to 12.2 cm (IQR 14.1), p = 0.05. No patients presented with retroperitoneal hemorrhage or recurrence during follow-up.

CONCLUSION

Treating renal AMLs with CA appears to be a safe and effective nephron-sparing approach and could be a valuable alternative to other treatment modalities. The low complication rate, absence of retreatment and a good preservation of renal function might allow treatment of even subclinical renal AMLs to minimize the risk of potentially life-threatening hemorrhage.

摘要

背景

小规模研究报告称,冷冻消融术(CA)是一种安全可行的微创保肾替代疗法,用于治疗肾血管平滑肌脂肪瘤(肾AML)。本研究的目的是探讨CA治疗肾AML患者的安全性和有效性。

材料与方法

回顾性分析丹麦奥胡斯大学医院在5年期间对19个肾AML病灶进行CA治疗的情况。

结果

7个病灶采用腹腔镜辅助CA治疗,其余12个病灶采用经皮超声引导下CA治疗。患者平均年龄为46岁[四分位间距(IQR)30],平均肿瘤体积为50.1 cm(IQR 53.3)。所有病例手术均有效进行,未转为开放手术,也未发生重大并发症。平均随访时间为25个月(IQR 13)。平均最大肿瘤体积从50.1 cm(IQR 53.3)缩小至12.2 cm(IQR 14.1),p = 0.05。随访期间无患者出现腹膜后出血或复发。

结论

用CA治疗肾AML似乎是一种安全有效的保肾方法,可能是其他治疗方式的有价值替代方案。低并发症发生率、无需再次治疗以及良好的肾功能保留情况可能使即使是亚临床肾AML也能得到治疗,以将潜在危及生命的出血风险降至最低。

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