Zhong Jim, Bambrook Janette, Bhambra Balbir, Smith Jonathan, Cartledge Jon, Ralph Christy, Vasudev Naveen, Whiteley Simon, Wah Tze
Diagnostic and Interventional Radiology Department, Institute of Oncology, St. James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, LS9 7TF, UK.
Department of Urology, St. James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, LS9 7TF, UK.
Cardiovasc Intervent Radiol. 2018 Feb;41(2):270-276. doi: 10.1007/s00270-017-1811-1. Epub 2017 Nov 28.
To prospectively evaluate the incidence of post-ablation syndrome (fever and flu-like symptoms) and impact on the quality of life in the first 10 days following percutaneous image-guided cryoablation for renal cell carcinoma (RCC).
A prospective study of all cryoablation procedures with biopsy proven RCC was conducted with institutional review board approval between 08/2012 and 04/2016. Sixty-four patients (43 males and 21 females) underwent cryoablation. Mean age was 68 (range 24-86). A telephone questionnaire survey was conducted on days 1, 3, 5, 7 and 10 following cryoablation, and complications were recorded. Data collected included temperature, degree of flu-like symptoms, severity of pain, percentage of pain relief with analgesics, interference with general activity and with work (graded on a 0-10 Numeric Intensity Scale).
Following cryoablation, six patients (9%) out of 64 developed post-ablation syndrome. Thirty-three patients (52%) developed flu-like symptoms only, which completely resolved by day 10 in 25 patients (39%). One patient had pyrexia only, which was self- limiting by day 10. Twenty-four patients (38%) were asymptomatic. Pain (mean score = 2.1) and interference on general activities (mean score = 1.8) and work (mean score = 2) following cryoablation peaked on day 3 and improved subsequently. Forty-six patients (72%) had 90-100% pain relief by day 10. No major complications were observed.
The full spectrum of post-ablation syndrome following cryoablation occurs in approximately 9% of patients; however, 61% of patients experience flu-like symptoms in the first 10 days, which are self-limiting.
前瞻性评估经皮影像引导下冷冻消融治疗肾细胞癌(RCC)后10天内消融后综合征(发热和流感样症状)的发生率及其对生活质量的影响。
在2012年8月至2016年4月期间,经机构审查委员会批准,对所有经活检证实为RCC的冷冻消融手术进行了一项前瞻性研究。64例患者(43例男性和21例女性)接受了冷冻消融治疗。平均年龄为68岁(范围24 - 86岁)。在冷冻消融后的第1、3、5、7和10天进行电话问卷调查,并记录并发症。收集的数据包括体温、流感样症状程度、疼痛严重程度、镇痛药缓解疼痛的百分比、对一般活动和工作的干扰(采用0 - 10数字强度量表评分)。
冷冻消融后,64例患者中有6例(9%)出现消融后综合征。33例患者(52%)仅出现流感样症状,其中25例患者(39%)在第10天时症状完全缓解。1例患者仅出现发热,至第10天时自行缓解。24例患者(38%)无症状。冷冻消融后疼痛(平均评分 = 2.1)、对一般活动的干扰(平均评分 = 1.8)和对工作的干扰(平均评分 = 2)在第3天达到峰值,随后有所改善。46例患者(72%)在第10天时疼痛缓解90% - 100%。未观察到重大并发症。
冷冻消融后消融后综合征的总体发生率约为9%;然而,61%的患者在最初10天内出现流感样症状,这些症状可自行缓解。