Efficacy and safety of percutaneous CT/ultrasound-guided bipolar radiofrequency ablation in the treatment of small renal mass under local anesthesia
10.3969/j.issn.1009-8291.2024.09.012
- VernacularTitle:局部麻醉下CT/超声双引导经皮双极射频消融术治疗偶发性肾脏小肿瘤的疗效及安全性
- Author:
Yifan SUN
1
;
Haifeng HUANG
;
Wei WANG
;
Fan ZHANG
;
Shengjie ZHANG
;
Guanchen ZHU
;
Hongqian GUO
Author Information
1. 南京大学医学院附属鼓楼医院泌尿外科,江苏南京 210008
- Keywords:
radiofrequency ablation;
robotic-assisted partial nephrectomy;
small renal mass;
renal function
- From:
Journal of Modern Urology
2024;29(9):809-814
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare and analyze the efficacy and risks of percutaneous CT/ultrasound-guided bipolar radiofrequency ablation(RFA)under local anesthesia with robotic-assisted laparoscopic partial nephrectomy(RAPN)for the treatment of sporadic small renal mass.Methods A retrospective study was conducted on 93 consecutive patients with T1a stage small renal mass during Mar.2019 and Oct.2021.Among them,51 underwent RAPN,and 42 underwent RFA.General information,tumor characteristics,perioperative and follow-up data were collected and statistically analyzed.Results There were no significant differences in general information and tumor characteristics between the two groups(P＞0.05).The operation time[(96.0±20.0)min vs.(113.5±24.1)min,P＜0.001],hospital stay[(3.5±0.8)day vs.(6.9±1.8)day,P＜0.001],and hospital costs[(2.4±0.7)ten thousand yuan vs.(6.6±0.4)ten thousand yuan,P＜0.001]were significantly decreased in the RFA group than in the RAPN group.There were no significant differences in the incidence of perioperative complications and long-term disease-free survival rate between the two groups(P＞0.05).However,the difference between one-year postoperative estimated glomerular filtration rate(eGFR)and preoperative eGFR was significantly lower in the RFA group than in the RAPN group[-2.3(-4.7-1.3)mL/(min·1.73 m2)vs.-5.0(-9.1 2.8)mL/(min·1.73 m2),P=0.003],and the reduction of one-year postoperative creatinine and preoperative creatinine was slightly lower in the RFA group than in the RAPN group[4.0(-0.2-5.5)μmol/L vs.4.5(1.8-9.2)μmol/L,P=0.122].Conclusion RFA can achieve comparable disease-free survival rate as RAPN in the treatment of T1a renal tumor,and can effectively preserve renal function,reduce medical costs,save medical resources,and lower the incidence of perioperative complications.
