微波消融治疗肾脏小肿块的临床安全性和有效性。

IF 3.1 3区 医学 Q1 UROLOGY & NEPHROLOGY International Braz J Urol Pub Date : 2024-05-01 DOI:10.1590/S1677-5538.IBJU.2024.0017
Ashley Foret, Christopher B Haaga, Shivani Jain, Chelsea O Baumgartner, Megan Escott, Benjamin R Henderson, Sean T O'Brien, Scott E Delacroix, Jessie R R Gills, Mary E Westerman
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引用次数: 0

摘要

目的:CT引导下的MWA是一种安全有效的工具,应用于治疗肾脏小肿块(SRM)。我们旨在通过研究复发、治疗成功率、肾功能变化和并发症等患者预后来阐明 CT 引导下 MWA 的实用性:方法:我们对2015年至2022年期间连续接受同日肾肿块活检(RMB)和CT引导下MWA的SRM患者进行了回顾性研究。根据Clavien-Dindo系统和术后30天以上的eGFR变化,通过30天并发症评估治疗安全性。疗效根据局部复发率和治疗不完全率进行定义,并采用卡普兰-梅耶法进行计算:结果:104 名患者共发现 108 个肾肿块。总并发症发生率为 7.4%(8/108),其中 4 例为重大并发症(3.7%)。在消融术后30天以上有肾功能的患者中,eGFR中位数为47.2(IQR:36.0,57),而消融术前为52.3(IQR:43.7,61.5),P结论:随着医学领域不断向微创介入发展,MWA 为治疗肾脏肿块提供了一种有价值的工具。由于主要并发症和复发率较低,我们的研究结果支持将 CT 引导下的 MWA 作为治疗 SRM 的工具。
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Clinical safety and efficacy of microwave ablation for small renal masses.

Purpose: CT-guided MWA is a safe and effective tool that should be utilized in the treatment of small renal masses (SRMs). We aim to clarify the utility of CT-guided MWA by examining patient outcomes such as recurrence, treatment success, changes in renal function, and complications.

Methods: A retrospective review of consecutive patients with SRMs who underwent same day renal mass biopsy (RMB) and CT-guided MWA between 2015 and 2022 was performed. Treatment safety was assessed by 30-day complications according to the Clavien-Dindo system and change in eGFR >30 days post-procedure. Treatment efficacy was defined by local recurrence and incomplete treatment rates and calculated using the Kaplan-Meier method.

Results: A total of 108 renal masses were found in 104 patients. The overall complication rate was 7.4% (8/108), of which 4 were major complications (3.7%). For those with renal function available >30 days post ablation, the median eGFR was 47.2 (IQR: 36.0, 57), compared to 52.3 (IQR: 43.7, 61.5) pre-ablation, p<0.0001. 5-year local recurrence free survival was 86%. Among those with biopsy proven malignancy (n= 66), there were five local recurrences (7.54%) occurring at a median of 25.1 months (IQR 19.9, 36.2) and one case (1.5%) of incomplete treatment.

Conclusions: As the medical field continues to evolve towards less invasive interventions, MWA offers a valuable tool in the management of renal masses. With low major complication and recurrence rates, our findings support the utility of CT-guided MWA as a tool for treatment of SRMs.

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来源期刊
International Braz J Urol
International Braz J Urol UROLOGY & NEPHROLOGY-
CiteScore
4.60
自引率
21.60%
发文量
246
审稿时长
6-12 weeks
期刊介绍: Information not localized
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