比較經皮穿刺與腹腔鏡腎臟腫瘤的冷凍治療
劉惠瑛1*、許齡內1*、沈書慧2*、李維菁1*、鄭元佐1*、江博暉1*
高雄長庚紀念醫院 泌尿科
台北榮民總醫院 放射科
Comparisons of percutaneous versus retroperitoneoscopic cryoablation for renal masses
Hui-Ying Liu1*, Lin-Nei Hsu1*, Shu-Huei Shen2*, Wei-Ching Lee1, Yuao-Tso Cheng1, Po-Hui Chiang1*
1 Department of Urology, Chang Gung Memorial Hospital – Kaohsiung Medical
Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan
2 Department of Radiology, Taipei Veterans General Hospital, Taiwan
Purpose:
Preservation of renal function and oncological control are important while managing renal tumors in patients. We compare perioperative and intermediate-term outcomes of renal percutaneous and retroperitoneoscopic cryoablation (PCA and RCA) in patients with renal neoplasms.
Materials and methods:
We identified 108 patients from two medical centers, where 63 patients received CT-guide percutaneous renal cryoablation and 45 patients underwent retroperitoneoscopic renal cryoablation from August 2009 and to May 2015. We compared preoperative and postoperative parameters, such as age, body mass index (BMI), tumor size, estimated glomerular filtration rate (eGFR), hemoglobin, operative time, tumor type, Clavien classification, and tumor recurrence by statistical analysis of t-test and chi-square test.
Results:
Retroperitoneoscopic method had shorter operative time and increased pathologic diagnosis of renal tumor. Percutaneous method had shorter length of stay and provided alternative access for patients with high BMI. No patients developed deterioration of renal function in both PCA and RCA groups during the follow-up. However, poor oncologic outcome were significant in those with tumor size > 4 cm.
Conclusions:
In intermediate-term of follow-up, PCA and RCA had equal efficacy in oncological outcome. Patients underwent RCA had shorter operative time and higher pathologic diagnosis of renal tumor than PCA. If the renal tumor size is less than 4 cm, good oncological control were noted in both PCA and RCA groups.