肺射频消融术后使用明胶海绵鱼雷时的胸管置入率

Pauline Graveleau , Éric Frampas , Christophe Perret , Stéphanie Volpi , François-Xavier Blanc , Thomas Goronflot , Renan Liberge
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摘要

目的评估肺部肿瘤病变经皮射频消融术(PRFA)后使用明胶鱼雷栓塞技术减少胸管置入率和住院时间的有效性,以及这种栓塞技术的安全性。两组患者进行了比较,42 例 PRFA 采用了明胶鱼雷栓塞技术(明胶组),72 例未采用明胶鱼雷栓塞技术(对照组)。手术由七位介入放射科医生之一使用 LeVeen CoAccess™ 探头进行。结果明胶组的胸管置入率明显低于对照组(3 [7.1 %] vs. 27 [37.5 %],p < 0,001)。多变量分析显示,胸管置入与明胶鱼雷栓塞技术之间存在显著关联(OR:0.09;95 % CI:0.02-0.32;P = 0.0006)。两组患者的住院时间无明显差异。多变量分析显示,住院时间与明胶鱼雷栓塞技术之间没有明显关系。结论在对肺部肿瘤病灶进行 PRFA 后采用明胶鱼雷栓塞技术可显著降低患者的胸管置入率。住院时间没有明显缩短。明胶组未发生重大并发症。
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Chest tube placement incidence when using gelatin sponge torpedoes after pulmonary radiofrequency ablation

Purpose

To assess the efficacy of the gelatin torpedoes embolization technique after lung neoplastic lesions percutaneous radiofrequency ablation (PRFA) to reduce chest tube placement rate and hospital length of stay, and the safety of this embolization technique.

Materials and methods

A total of 114 PRFA of lung neoplastic lesions performed in two centers between January 2017 and December 2022 were retrospectively reviewed. Two groups were compared, with 42 PRFA with gelatin torpedoes embolization technique (gelatin group) and 72 procedures without (control group). Procedures were performed by one of seven interventional radiologists using LeVeen CoAccess™ probe. Multivariate analyses were performed to identify risk factors for chest tube placement and hospital length of stay.

Results

There was a significantly lower chest tube placement rate in the gelatin group compared to the control group (3 [7.1 %] vs. 27 [37.5 %], p < 0,001). Multivariate analysis showed a significant association between chest tube placement and gelatin torpedoes embolization technique (OR: 0.09; 95 % CI: 0.02–0.32; p = 0.0006). No significant difference was found in hospital length of stay between the two groups. Multivariate analysis did not show a significant relationship between hospital length of stay and gelatin torpedoes embolization technique. No embolic complication occurred in the gelatin group.

Conclusion

Gelatin torpedoes embolization technique after PRFA of lung neoplastic lesions resulted in significantly reduced chest tube placement rate in our patient population. No significant reduction in hospital length of stay was observed. No major complication occurred in the gelatin group.

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