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液氮冷冻消融:肺、骨和软组织肿瘤冷冻消融的并发症发生率。

Liquid nitrogen-based cryoablation: complication rates for lung, bone, and soft tissue tumors cryoablation.

机构信息

Department of Interventional Radiology, Istituto Europeo di Oncologia (IRCCS), Milan, Via Giuseppe Ripamonti 435, Milan-20141, Italy.

Selayang Hospital, Selangor, Malaysia.

出版信息

Br J Radiol. 2024 Nov 1;97(1163):1863-1869. doi: 10.1093/bjr/tqae171.

Abstract

OBJECTIVE

This study aimed to assess the complication rate during and 24 hours after cryoablation in lung, bone, and soft tissue tumors.

METHODS

We reviewed complications in a total of 85 consecutive patients who underwent cryoablation using a liquid nitrogen-based system in various lesions between April 2017 and October 2022. There were no liver and renal lesions. Complications were categorized using the Society of Interventional Radiology classification.

RESULTS

Eighty-five patients were treated for 96 lesions in the bone (36.4%; 35 of 96), lung (18.8%; 18 of 96), and soft tissue (44.8%; 43 of 96). The primary technical success rate was 97.7% (83 of 85). The total grade 2 and 1 complication rates were 5.2% (5/96) and 20.8% (20/96), respectively. Two patients had asymptomatic pulmonary embolisms incidentally noted at the 24-hour follow-up computed tomography (grade 2). The most frequent complications were simple and hemorrhagic pleural effusions (18.7%; 18 of 96). Lung procedures had the highest complication rate, where 13 patients (72.2%; 13 of 18) reported complications, including 2 cases of symptomatic hydropneumothorax requiring drainage (grade 2) and an additional 2 days of hospital stay. Eight patients (24.2%; 8 of 33) with bone lesions and 4 (9.3%; 4 of 43) with soft tissue lesions experienced complications.

CONCLUSION

Cryoablation using a liquid nitrogen-based system is safe, with only minor complications observed.

ADVANCES IN KNOWLEDGE

This study provides data on the safety of liquid nitrogen-based percutaneous cryoablation in tumors located in lung, in bones and in soft tissues. Despite using larger diameter cryoprobes than those typically reported with argon-based system, our experience shows that complications are mostly low and comparable in frequency and severity.

摘要

目的

本研究旨在评估肺、骨和软组织肿瘤冷冻消融术中及术后 24 小时的并发症发生率。

方法

我们回顾性分析了 2017 年 4 月至 2022 年 10 月期间,使用基于液氮的系统对 85 例不同部位病变患者行冷冻消融治疗的资料。本研究不包括肝、肾病变。并发症采用介入放射学会分类。

结果

85 例患者共 96 个病灶接受了治疗,其中骨病灶 36.4%(35/96),肺病灶 18.8%(18/96),软组织病灶 44.8%(43/96)。主要技术成功率为 97.7%(83/85)。总 grade 2 和 grade 1 并发症发生率分别为 5.2%(5/96)和 20.8%(20/96)。2 例患者在 24 小时随访 CT 时偶然发现无症状性肺栓塞(grade 2)。最常见的并发症是单纯性和出血性胸腔积液(18.7%,18/96)。肺手术的并发症发生率最高,18 例(72.2%,13/18)患者出现并发症,包括 2 例需要引流的症状性液气胸(grade 2)和另外 2 天的住院时间。8 例(24.2%,8/33)骨病灶和 4 例(9.3%,4/43)软组织病灶患者出现并发症。

结论

使用基于液氮的系统进行冷冻消融术是安全的,仅观察到轻微并发症。

知识进展

本研究提供了关于使用基于液氮的经皮冷冻消融术治疗位于肺、骨和软组织肿瘤的安全性数据。尽管使用的冷冻探针直径大于通常报道的基于氩气系统的直径,但我们的经验表明,并发症大多较低,在频率和严重程度上相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7c7/11491613/3ea4bc11247f/tqae171f1.jpg

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