开放性冷循环射频消融治疗近肾门处肾错构瘤的临床疗效

目的：探讨开放性冷循环射频消融治疗近肾门处错构瘤的可行性及临床疗效。方法：对4例近肾门处错构瘤患者实施开放性错构瘤切除，肿瘤基地部行冷循环射频消融治疗。肿瘤位于左肾l例，右肾3例。肿瘤最大径5～8．5cm。术后采用CT、超声造影定期随访。结果：平均手术时间（95i20）min，平均出血量（100±28）ml，术中均未输血。术后疼痛3例，术后均有发热，体温（39．0±0．5）℃。术后6周，4个病灶均完全消融。术后有1例患者血红蛋白降低明显但未输血，术后血肌酐、红细胞沉降率较术前无明显变化；肿瘤较大者术后短期内肾小球滤过率减低。4例患者获得3个月后CT复查，4例病灶完全消融，随访时间2～18个月，未见肿瘤复发。结论：冷循环射频消融是一种安全有效的治疗新方法；采用开放性射频消融保留肾单位手术治疗近肾门处肾错构瘤是一种可供选择的方法，临床效果比较理想。

Clinical Efficacy of Open Cool-tip Radiofrequency Ablation for Renal Angiomyolipoma

Objective：To evaluate the clinical feasibility and efficacy of cool-tip radiofrequency ablation for renal angiomyolipoma closed to the renal hilum. Methods：4 cases with renal angiomyolipoma closed to the renal hilum（1 cases of left renal cell, 3cases of right renal cell）were performed by open resection. The maximum diameter of the tumors were 5-8.5 cm. Follow up with CT and ultrasonic contrast. Results：The mean time of the operations was （95 ± 20） min, and the mean blood loss was（ 100 ±28） ml. None of the cases were accepted blood transfusion durning the operation. 3 cases had postoperative pain and fever, body temperature （39 . 0 ± 0 . 5） ℃. After 6 weeks operation, all of the 4 lesions were complete ablation. Hemoglobin of 1 case significantly lowered after operation, but not accepted blood transfusion. Postoperative serum creatinine, erythrocyte sedimentation rate had no significant changes. The glomerular filtration rate of that patient with greater tumor decreased in short period after operation. All cases underwent enhanced CT examination 3 months after the treatment , showed completely necrosis of tumor. Follow-up for 2-18 months, all of the 4 cases survived. Conclusions：The cool tip radiofrequency ablation for renal angiomyolipoma closed to the renal hilum is an accurate and effective intervention with a relatively low incidence of complications, and It is a safe and feasible nephron sparing alternative for the treatment of renal angiomyolipoma closed to the renal hilum.