Gollapudi Lakshmi Asritha, Tyberg Amy
Department of Medicine, Division of Gastroenterology, New York Medical College at Westchester Medical Center, Valhalla, NY, USA.
Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
Transl Gastroenterol Hepatol. 2022 Apr 25;7:18. doi: 10.21037/tgh-2020-11. eCollection 2022.
Surgical resection remains the gold standard for pancreatic cancer, high-risk pancreatic neuroendocrine tumors (PNETs) and pancreatic cystic neoplasms (PCNs). However, a majority of pancreatic cancers are unresectable at the time of diagnosis. In addition, surgical resection of pancreatic lesions can be associated with morbidity and mortality. A less-invasive alternative therapeutic intervention to avoid short term and long-term adverse events is desirable, as is a minimally-invasive palliative therapy for unresectable or recurrent pancreatic cancers. Endoscopic ultrasound guided radiofrequency ablation (EUS-RFA) allows for selective tissue ablation with minimal injury to the surrounding tissue. EUS-RFA of pancreatic tumors has shown high clinical and technical success with acceptable side effects in pancreatic lesions, lymph nodes, and the celiac plexus. This paper will review the pathophysiology, available technology, safety and efficacy, and future directions of EUS-RFA.
手术切除仍然是胰腺癌、高危胰腺神经内分泌肿瘤（PNETs）和胰腺囊性肿瘤（PCNs）的金标准。然而，大多数胰腺癌在诊断时已无法切除。此外，胰腺病变的手术切除可能会导致发病和死亡。一种侵入性较小的替代治疗干预措施，以避免短期和长期不良事件，这是可取的，对于无法切除或复发的胰腺癌，微创姑息治疗也是如此。内镜超声引导下射频消融（EUS-RFA）能够在对周围组织损伤最小的情况下进行选择性组织消融。胰腺肿瘤的EUS-RFA在胰腺病变、淋巴结和腹腔神经丛中已显示出较高的临床和技术成功率，且副作用可接受。本文将综述EUS-RFA的病理生理学、现有技术、安全性和有效性以及未来发展方向。
