Radiofrequency ablation (RFA) therapy for renal angiomyolipoma (AML): an alternative to angio-embolization and nephron-sparing surgery
Radiofrequency ablation (RFA) therapy for renal angiomyolipoma (AML): an alternative to angio-embolization and nephron-sparing surgery
复制标题
DOI：
10.1111/j.1464-410x.2011.10376.x
复制
发表时间：
2012-02-01
影响因子：
4.5
通讯作者：
Leveillee, Raymond J.
中科院分区：
文献类型：
--
作者：
Castle, Scott M.;Gorbatiy, Vladislav;Leveillee, Raymond J.
目的：证明射频消融（RFA）是治疗肾血管平滑肌脂肪瘤（AML）的安全有效的方法。患者和方法回顾我们的前瞻性数据库显示，从2002年2月至2010年3月，15例术中活检证实的肾AML患者接受RFA。Boulder，CO，USA）或RITA（TM）（Angiodynamics（R），莱瑟姆，纽约州，美国）RFA探头。1个月、6个月、1年和此后每年进行CT检查。2例男性和13例女性患者，7例左侧肿瘤和8例右侧肿瘤，平均（范围）大小为2.6（1.0-3.7）cm行腹腔镜（5例）或CT引导（10例）RFA，无术中并发症发生。轻微并发症包括一过性血尿和肋间神经切断。手术并发症包括肺炎和心肌梗死。平均随访21个月时，没有放射学证据表明AML（CT增强）持续存在。CONCLUSIONSRFA的止血作用使肾脏可疑AML病变得到治疗，而无出血并发症。避免了手术摘除或栓塞的风险。RFA治疗肾脏AML安全有效。
OBJECTIVESTo show that radiofrequency ablation (RFA) is safe and effective treatment for renal angiomyolipoma (AML). Current treatments to reduce the risk of haemorrhage include tumour extirpation, angio-embolization, or ablative therapy.PATIENTS AND METHODSReview of our prospective database revealed 15 patients with intraoperative biopsy confirmed renal AML undergoing RFA from February 2002 to March 2010.Patients underwent either laparoscopic or computed tomography (CT)-guided percutaneous RFA using either the Cool-tip (TM) (Covidien, Inc. Boulder, CO, USA) or RITA (TM) (Angiodynamics (R), Latham, NY, USA) RFA probe.CT at 1 month, 6 months, 1 year, and annually thereafter.RESULTSIn all, two male and 13 female patients with seven left-sided and eight right-sided tumours with a mean (range) size of 2.6 (1.0-3.7) cm underwent laparoscopic (five) or CT-guided (10) RFA.No intraoperative complications occurred. Minor complications included transient haematuria and intercostals nerve transection. Surgical complications included pneumonia and myocardial infarction.There was no radiographic evidence of persistent AML (CT enhancement) at a mean follow-up of 21 months.CONCLUSIONSThe haemostatic effect of RFA allows renal lesions suspicious for AML to be treated without bleeding complications.Avoids surgical risk of extirpation or embolization.RFA for renal AML is safe and effective.