经皮微波消融治疗贴近胸膜非小细胞肺癌时应用水分离技术以缓解疼痛。

Hydrodissection technique for pain relief during peri-microwave ablation in patients with subpleural non-small cell lung cancers.

机构信息

Department of First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China.

Department of Oncology, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Lung Cancer Institute, Jinan, China.

出版信息

Int J Hyperthermia. 2024;41(1):2424897. doi: 10.1080/02656736.2024.2424897. Epub 2024 Nov 5.

DOI:10.1080/02656736.2024.2424897

PMID:39500486

Abstract

PURPOSE

This study aimed to assess the application value of the hydrodissection technique (HT) for pain relief during peri-microwave ablation (MWA) in patients with subpleural non-small cell lung cancers (NSCLCs).

METHODS

This retrospective study comprised 218 patients with subpleural NSCLCs who underwent computed tomography (CT)-guided percutaneous MWA. The patients were divided into two groups: HT-assisted MWA (HT group) and local pleural anesthesia (LPA)-assisted MWA (LPA group). Differences in the effective rates of pain relief during MWA, visual analog scale (VAS) scores post-MWA, complications, and complete ablative rates were assessed.

RESULTS

The HT group comprised 101 patients (62 males and 39 females; mean age, 61.93 ± 10.57 years), while the LPA group comprised 117 patients (66 males and 51 females; mean age, 62.95 ± 11.16 years). The effective rate of pain relief in the HT group (82/101 patients, 81.19%) was significantly higher than that in the LPA group (66/117 patients, 56.41%), ( < 0.0001). The VAS scores at 6, 12, 24, and 48 h post-MWA were not statistically different between the two groups. The incidence of pneumothorax (grade ≥3) was significantly lower in the HT group (11/101 patients, 10.89%) than in the LPA group (27/117, 23.07%), ( = 0.0161). The complete ablative rates at 1, 3, 6, 12, and 24 months post-MWA were comparable of two groups.

CONCLUSIONS

These results indicate that HT-assisted MWA of patients with subpleural NSCLCs could effectively provide pain relief and decrease the occurrence of pneumothorax, yielding a satisfactory local therapeutic response.

摘要

目的

本研究旨在评估水分离技术（hydrodissection technique，HT）在经皮 CT 引导下经皮微波消融（microwave ablation，MWA）治疗胸膜下非小细胞肺癌（non-small cell lung cancer，NSCLC）患者围消融期镇痛中的应用价值。

方法

本回顾性研究纳入了 218 例胸膜下 NSCLC 患者，所有患者均接受 CT 引导下经皮 MWA。患者分为 HT 辅助 MWA（HT 组）和局部胸膜麻醉（local pleural anesthesia，LPA）辅助 MWA（LPA 组）两组。评估两组 MWA 期间疼痛缓解的有效率、MWA 后视觉模拟评分（visual analog scale，VAS）、并发症及完全消融率的差异。

结果

HT 组 101 例（62 例男性，39 例女性；平均年龄 61.93±10.57 岁），LPA 组 117 例（66 例男性，51 例女性；平均年龄 62.95±11.16 岁）。HT 组疼痛缓解有效率（82/101 例，81.19%）明显高于 LPA 组（66/117 例，56.41%），（ <0.0001）。两组 MWA 后 6、12、24 和 48 h 的 VAS 评分无统计学差异。HT 组气胸（≥3 级）发生率（11/101 例，10.89%）明显低于 LPA 组（27/117 例，23.07%），（ =0.0161）。两组 MWA 后 1、3、6、12 和 24 个月的完全消融率相当。