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术中超声引导不可切除的非转移性胰腺恶性肿瘤姑息性射频消融术:一项初步观察性研究。

Intraoperative Ultrasound guided Palliative Radiofrequency Ablation of Unresectable Nonmetastatic Pancreatic Malignancies: A Pilot Observational Study.

机构信息

Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca; Medicover Hospital, Cluj-Napoca, Romania. .

Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca; Prof. Dr. Octavian Fodor Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania. .

出版信息

J Gastrointestin Liver Dis. 2024 Jul 13;33(3):372-378. doi: 10.15403/jgld-5712.

Abstract

BACKGROUND AND AIMS

Radiofrequency ablation of unresectable pancreatic tumors represents a palliative method in selected patients. The lack of standardization of the technique used as well as the non-homogeneous immediate and long-term results from the reports in the literature made us evaluate in a pilot study the application of a standardized technique through a surgical approach, with the evaluation of the immediate and long-term results.

METHODS

Ten consecutive patients diagnosed with unresectable nonmetastatic pancreatic adenocarcinoma were referred for radio-frequency ablation by surgical approach. For that, a UniBlate (AngioDinamics®) internal cooled electrode was used, under intraoperative ultrasound guidance. We analysed the morbidity, mortality and survival associated with this procedure. The median follow-up period was 12 months.

RESULTS

Intraoperative ultrasound was essential for guiding the procedure. No mortality and no major postoperative complications after intraoperative tumoral ablations were noted. The median survival after the procedure was 7.5 months.

CONCLUSIONS

Radiofrequency intraoperative ablation of unresectable pancreatic tumors is a feasible procedure, with low morbidity and mortality if standardized, being noninferior to palliative chemotherapy alone in regards with survival. A larger study is necessary to demonstrate the potential benefits in survival, the role of multidisciplinary selection being also mandatory.

摘要

背景和目的

对于某些选定的患者,无法切除的胰腺肿瘤的射频消融术代表一种姑息性治疗方法。由于文献报道中所使用的技术缺乏标准化以及即时和长期结果的不一致性,我们通过手术方法评估了一种标准化技术的应用,以评估即时和长期结果。

方法

连续 10 例被诊断为无法切除的非转移性胰腺腺癌的患者被推荐采用手术方法进行射频消融。为此,使用了 UniBlate(AngioDinamics®)内部冷却电极,在术中超声引导下进行。我们分析了与该手术相关的发病率、死亡率和存活率。中位随访时间为 12 个月。

结果

术中超声对于指导手术至关重要。未观察到术中肿瘤消融后的死亡率和重大术后并发症。术后中位生存时间为 7.5 个月。

结论

无法切除的胰腺肿瘤的术中射频消融是一种可行的方法,如果标准化,其发病率和死亡率较低,在生存方面并不劣于单纯的姑息性化疗。需要进行更大规模的研究来证明在生存方面的潜在获益,多学科选择的作用也是必不可少的。

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