Khan Faraz, Ho Andrew M, Jamal Joseph E, Gershbaum Meyer D, Katz Aaron E, Hoffmann Jason C
Department of Radiology, NYU Winthrop Hospital, 259 First Street, Mineola, NY 11501, USA.
Department of Urology, NYU Winthrop Hospital, 259 First Street, Mineola, NY 11501, USA.
Clin Imaging. 2018 Jul-Aug;50:62-67. doi: 10.1016/j.clinimag.2017.12.003. Epub 2017 Dec 12.
To review the technical success of image-guided percutaneous cryoablation of renal masses in difficult anatomic locations using adjunctive techniques to displace critical structures away from the ablation zone, while also reporting longer-term outcomes within this patient population.
An IRB approved, retrospective analysis of 92 renal masses treated with percutaneous cryoablation revealed 15 cases utilizing adjunctive techniques. Tumor size and distance to adjacent organ before and after adjunctive technique and long-term outcomes were evaluated.
The adjunctive techniques used were hydrodissection (n=15) and angioplasty balloon interposition (n=1). Before and after adjunctive technique, median tumor proximity to closest organ was 4mm and 26mm, respectively. All cases had appropriate ablation zones and protection of adjacent critical structures. There is no evidence of recurrence or complication on follow-up (median 51months).
Adjunctive techniques to ablate renal masses in difficult locations provide technical success, safety, and favorable long-term outcomes.
回顾使用辅助技术将关键结构从消融区域移开，对位于困难解剖位置的肾肿块进行图像引导下经皮冷冻消融的技术成功率，同时报告该患者群体的长期预后。
一项经机构审查委员会批准的对92例接受经皮冷冻消融治疗的肾肿块的回顾性分析显示，有15例采用了辅助技术。评估了辅助技术应用前后的肿瘤大小及与相邻器官的距离以及长期预后。
所采用的辅助技术为水分离术（n = 15）和血管成形术球囊置入（n = 1）。辅助技术应用前后，肿瘤与最接近器官的中位距离分别为4mm和26mm。所有病例均有合适的消融区域且相邻关键结构得到了保护。随访（中位时间51个月）期间无复发或并发症的证据。
用于消融困难位置肾肿块的辅助技术取得了技术成功、安全且长期预后良好。
