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热消融辅助腹腔镜肾部分切除术治疗临床 T1b 期肾肿瘤。

Thermal ablation assisted laparoscopic partial nephrectomy for clinical T1b renal tumors.

机构信息

Department of Urology, Shanghai Jiao Tong University School of Medicine affiliated Ren Ji Hospital, Shanghai, China.

出版信息

Minim Invasive Ther Allied Technol. 2022 Feb;31(2):179-184. doi: 10.1080/13645706.2020.1780451. Epub 2020 Jul 20.

Abstract

OBJECTIVE

To report our preliminary results of thermal ablation, including microwave and radiofrequency ablation assisted laparoscopic partial nephrectomy for cT1b renal tumors.

MATERIAL AND METHODS

A total of 56 patients with cT1b renal tumors who underwent microwave ablation or radiofrequency ablation assisted laparoscopic partial nephrectomy between January 2014 and May 2018 were enrolled. Thirty of them underwent microwave ablation assisted laparoscopic partial nephrectomy (MWA-LPN group), and the other 26 received radiofrequency ablation assisted laparoscopic partial nephrectomy (RFA-LPN group). Baseline, perioperative and follow-up data were compared between the two groups.

RESULTS

There were no statistical differences with respect to patients' gender, age, tumor size, RENAL score, BMI and estimated glomerular filtration rate between the MWA-LPN and RFA-LPN group, nor were any differences observed in warm ischemia time, post-operative complications and hospital stay. Patients in the MWA-LPN group had shorter median operative time ( = .012), less estimated blood loss ( = .023). Median follow-up was 36 months (range 12-64). Three-year cancer-specific and progression-free survival was 100% and 96.4%. The overall kidney recurrence rate was 3.6% in the present study.

CONCLUSIONS

Thermal ablation assisted laparoscopic partial nephrectomy is a safe, effective nephron-sparing treatment which provides acceptable results for selective cT1b renal tumors.

摘要

目的

报告我们采用热消融(包括微波和射频消融辅助腹腔镜部分肾切除术)治疗 cT1b 期肾肿瘤的初步结果。

材料与方法

回顾性分析 2014 年 1 月至 2018 年 5 月期间接受微波消融或射频消融辅助腹腔镜部分肾切除术治疗的 56 例 cT1b 期肾肿瘤患者的临床资料。其中 30 例患者接受微波消融辅助腹腔镜部分肾切除术(MWA-LPN 组),26 例患者接受射频消融辅助腹腔镜部分肾切除术(RFA-LPN 组)。比较两组患者的基线资料、围手术期和随访资料。

结果

两组患者的性别、年龄、肿瘤大小、RENAL 评分、BMI 和估算肾小球滤过率差异均无统计学意义,两组患者的热缺血时间、术后并发症和住院时间差异亦无统计学意义。MWA-LPN 组患者的中位手术时间更短( = .012),估计失血量更少( = .023)。中位随访时间为 36 个月(范围 12-64 个月)。3 年肿瘤特异性生存率和无进展生存率均为 100%。本研究中总的肾脏复发率为 3.6%。

结论

热消融辅助腹腔镜部分肾切除术是一种安全有效的保肾治疗方法,对于选择性 cT1b 期肾肿瘤可获得可接受的效果。

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