Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut.
Division of Gastroenterology and Hepatology, University of New Mexico, Albuquerque, New Mexico.
Clin Gastroenterol Hepatol. 2018 Jul;16(7):1007-1017. doi: 10.1016/j.cgh.2017.10.023. Epub 2018 Jan 17.
Radiofrequency ablation (RFA) is a well-established treatment for several benign, premalignant, and malignant disorders. Although the role of RFA has been clearly defined, new indications for luminal and extraluminal applications of endoscopic RFA-directed therapies have emerged. RFA has recently produced promising results in patients with a variety of gastrointestinal and hepatopancreatobiliary pathologies. For example, endoscopic RFA has been used to treat patients with gastric antral vascular ectasia, chronic radiation proctitis, malignant biliary strictures, and ampullary adenomas with intraductal extension. Furthermore, endoscopic ultrasound-guided RFA appears to be an effective, minimally invasive treatment for ablation of solid and cystic lesions-particularly in the pancreas. We review the newer indications for RFA and discuss potential limitations of endoscopic RFA.
射频消融(RFA)是治疗多种良性、癌前病变和恶性疾病的成熟方法。尽管 RFA 的作用已得到明确界定,但内镜 RFA 引导治疗的管腔和腔外应用的新适应证已经出现。RFA 最近在治疗多种胃肠道和肝胆胰疾病患者方面取得了有前景的结果。例如,内镜 RFA 已用于治疗胃窦血管扩张症、慢性放射性直肠炎、恶性胆道狭窄和壶腹腺瘤伴腔内延伸。此外,内镜超声引导下 RFA 似乎是一种有效的、微创的消融治疗方法,适用于治疗实性和囊性病变,尤其是胰腺病变。我们综述了 RFA 的新适应证,并讨论了内镜 RFA 的潜在局限性。