Computerized tomography guided percutaneous renal cryoablation with the patient under conscious sedation: Initial clinical experience
Computerized tomography guided percutaneous renal cryoablation with the patient under conscious sedation: Initial clinical experience
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DOI：
10.1016/s0022-5347(05)00247-8
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发表时间：
2006-02-01
影响因子：
6.6
通讯作者：
Solomon, SB
中科院分区：
文献类型：
--
作者：
Gupta, A;Allaf, ME;Solomon, SB
目的：材料与方法：对20例患者在清醒镇静状态下进行CT引导下经皮肾穿刺冷冻消融术治疗27例肿瘤。符合条件的患者肿瘤小于或等于5 cm，并且是较差的手术候选者或需要保留肾单位治疗。肿瘤根据其与肾窦脂肪的关系分为中心性或非中心性。在冷冻消融术期间，通过实时CT成像监测术中活性冰球形成，以确保足够的肿瘤覆盖。术后随访成像获得定期intervention.Results：我们的方法似乎在技术上可行的27冷冻消融进行，只有1个并发症发生在一个大的，位于中央的肿瘤患者需要输血。到目前为止，我们有12例患者的16个肿瘤，影像学随访1个月或更长时间（平均随访5.9个月）。该组的平均基线肿瘤大小为2.5 cm，其中11个小（3 cm或更小）和5个大（大于3 cm）肿瘤。5例位于中心，11例位于非中心。初步数据表明，16冷冻消融肿瘤15没有表现出增强followup.Conclusions的迹象：CT引导下经皮肾冷冻消融术似乎是一个可行的治疗选择小，非中心位于肾肿瘤。虽然早期结果似乎很有希望，但需要更长时间的随访才能更清楚地确定这种治疗方法的作用。
Purpose: We report on our initial clinical experience with CT guided percutaneous renal cryoablation.Materials and Methods: CT guided percutaneous renal cryoablation was performed on 27 tumors using conscious sedation in 20 patients. Eligible patients had tumors of 5 cm or less and were poor surgical candidates or otherwise warranted nephron sparing treatment. Tumors were classified as central or noncentral depending on their relationship to the renal sinus fat. During cryoablation intraoperative active ice ball formation was monitored with real-time CT imaging to ensure adequate tumor coverage. Postoperative followup imaging was obtained at regular intervals.Results: Our method appears technically feasible as of the 27 cryoablations performed, only 1 complication occurred requiring blood transfusion in a patient with a large, centrally located tumor. To date we have 16 tumors in 12 patients with imaging followup of 1 month or more (mean followup 5.9 months). Mean baseline tumor size in this group was 2.5 cm with 11 small (3 cm or less) and 5 large (more than 3 cm) tumors. Of the tumors 5 were centrally located and 11 were noncentrally located. Preliminary data suggest that of the 16 cryoablated tumors 15 showed no signs of enhancement on followup.Conclusions: CT guided percutaneous renal cryoablation appears to be a feasible treatment option for small, noncentrally located renal tumors. While early results appear promising, longer followup is needed to more clearly define the role of this treatment method.