Adebanjo Ganiyat Adenike Ralitsa, Bertolotti Lorenzo, Iemma Enrico, Martini Chiara, Arrigoni Francesco, Ziglioli Francesco, Maestroni Umberto, De Filippo Massimo
Department of Medicine and Surgery, Section of Radiology, University of Parma, Maggiore Hospital, Via Gramsci 14, 43126 Parma, Italy.
Department of Medicine and Surgery, Section of Radiology, University of Parma, Maggiore Hospital, Via Gramsci 14, 43126 Parma, Italy.
Eur J Radiol. 2024 Dec;181:111759. doi: 10.1016/j.ejrad.2024.111759. Epub 2024 Sep 26.
The treatment of renal tumors is dictated by the results acquired from renal imaging, which play a crucial role in determining the appropriate strategy and surgical plan. Radiofrequency ablation, microwave ablation, and cryoablation are established percutaneous thermal ablation procedures that have widespread recognition. The objective of this scholarly article is to present a comprehensive summary of the application of the primary thermal protection strategies of the structures adjacent to renal tumors, in particular the effectiveness in terms of safety of hydrodissection and pyeloperfusion, in the context of percutaneous thermal ablation for renal tumors.
A literature search was conducted in PubMed in April 2023 using the keywords "hydrodissection", "hydrodisplacement", "renal", "kidney", "percutaneous ablation", "cryoablation", "microwave", "radiofrequency", and "pyeloperfusion". No language restriction was applied.
Our study yielded a total of 676 cases describing the use of either hydrodissection or pyeloperfusion in conjunction with percutaneous thermal ablation. The fluids employed for displacing the neighboring structures encompassed saline solution, a mixture of saline solution and iodinated contrast, 5% dextrose in water, iodinated contrast in dextrose solution, lactated singer solution, and iodinated contrast.
By using these procedures effectively, a greater number of ablations could be performed on anterior or lower polar renal tumors, sometimes excluded from these treatments due to the high risk of causing damage to adjacent anatomical structures.
肾肿瘤的治疗取决于肾脏成像所获得的结果，肾脏成像在确定合适的治疗策略和手术方案中起着至关重要的作用。射频消融、微波消融和冷冻消融是已得到广泛认可的经皮热消融手术。这篇学术文章的目的是全面总结在肾肿瘤经皮热消融过程中，对肾肿瘤邻近结构的主要热保护策略的应用，特别是水分离和肾盂灌注在安全性方面的有效性。
2023年4月在PubMed上进行文献检索，使用关键词“水分离”“水移位”“肾”“肾脏”“经皮消融”“冷冻消融”“微波”“射频”和“肾盂灌注”。不设语言限制。
我们的研究共纳入676例描述水分离或肾盂灌注联合经皮热消融使用情况的病例。用于移位邻近结构的液体包括生理盐水、生理盐水与碘化造影剂的混合物、5%葡萄糖水溶液、葡萄糖溶液中的碘化造影剂、乳酸林格溶液和碘化造影剂。
通过有效使用这些手术方法，可以对肾前侧或下极肿瘤进行更多的消融，这些肿瘤有时因对相邻解剖结构造成损伤的风险高而被排除在这些治疗之外。
