Time-Dependent Effects of Cryoablation for Renal Tumor on Overall and Split Renal Function
Time-Dependent Effects of Cryoablation for Renal Tumor on Overall and Split Renal Function
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DOI：
10.1016/j.jvir.2018.10.017
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发表时间：
2019-03-01
影响因子：
2.9
通讯作者：
Inoue, Keiji
中科院分区：
文献类型：
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作者：
Yoshimatsu, Rika;Yamagami, Takuji;Inoue, Keiji
目的：评估经皮肾细胞癌冷冻消融术对受累肾功能的影响。材料和方法：2016年6月至2017年9月，在我们的机构，12例不能手术的患者接受了15次冷冻消融治疗17个小肾肿瘤。其中，9例接受11次冷冻消融的患者是本研究的重点。对于这些患者，通过回顾性审查临床记录，研究了术后肾功能的时间依赖性变化。评估了冷冻消融术前和冷冻消融术后1周、1-2个月和6个月以上使用99 mTc-MAG 3（99 mTc-MAG 3）进行的估计肾小球滤过率（eGFR）和闪烁扫描。结果：平均基线eGFR为76.88 +/- 29.82 ma/min/1.73 m（2）（平均标准差;范围，23.4-112.5）。冷冻消融术后1周、1-2个月和6个月以上的平均eGFR为74.56 +/- 26.68 mL/min/1.73 m（2）（21.0-101.1）、69.5 ± 25.28 mL/min/1.73 m（2）（24.1-105.6）和75.08 ± 26.25 mL/min/1.73 m（2）（29.0-107.3）。变化无统计学意义（分别为P = 0.6044、P = 0.6699和P = 0.9038）。关于分裂肾功能，通过99 mTc-MAG 3测定的受累肾脏的平均基线贡献为47.27% +/- 6.14（38.8%-57.0%）。冷冻消融后1周、1-2个月、冷冻消融后和冷冻消融后6个月以上受累肾脏的平均贡献分别为44.40% +/- 5.37（38.3%-53.6%）、44.57% +/- 6.52（34.35%-55.0%）和45.41% ± 7.77（34.4%-56.5%）。与基线的差异是显着的最早的两个阶段（P = 0.0473和P = 0.0334，分别），但不是后期（P = 0.2532）。结论：结果表明，总肾功能不恶化后冷冻消融术;然而，受影响的肾脏功能恶化后冷冻消融术，但后来部分恢复。
Purpose: To evaluate the influence of percutaneous cryoablation for renal cell carcinoma on function of the affected kidney.Materials and Methods: Between June 2016 and September 2017 at our institution, 12 inoperable patients underwent 15 cryoablation sessions for 17 small renal tumors. Of these, 9 patients who underwent 11 sessions of cryoablation were the focus of this study. For those patients, time-dependent changes in postoperative renal function were investigated by a retrospective review of clinical records. Evaluated were the estimated glomerular filtration rate (eGFR) and scintigraphy using 99m technetium-mercaptoacetyltriglycine (99mTc-MAG3) before and 1 week, 1-2 months, and more than 6 months after cryoablation.Results: Mean baseline eGFR was 76.88 +/- 29.82 ma/min/1.73 m(2) (mean standard deviation; range, 23.4-112.5). Mean eGFR 1 week, 1-2 months, and more than 6 months after cryoablation were 74.56 +/- 26.68 mL/min/1.73 m(2) (21.0-101.1), 69.5 +/- 25.28 mL/min/1.73 m(2) (24.1-105.6), and 75.08 +/- 26.25 mIlmin/1.73 m(2) (29.0-107.3), respectively. Changes were statistically insignificant (P = .6044, P = .6699, and P = .9038, respectively). Regarding split renal function, the mean baseline contribution of the affected kidney determined by 99mTc-MAG3 was 47.27% +/- 6.14 (38.8%-57.0%). Mean contributions of the affected kidney 1 week after, 1-2 months; after, and more than 6 months after cryoablation were 44.40% +/- 5.37 (38.3%-53.6%), 44.57% +/- 6.52 (34.35%-55.0%), and 45.41% 7.77 (34.4%-56.5%), respectively. Differences from baseline were significant for the earliest 2 periods (P =.0473 and P =.0334, respectively) but not the later period (P = .2532).Conclusions: Results suggested that total renal function does not worsen after cryoablation; however, function of the affected kidney worsened after cryoablation but later partially recovered.