Böbrek Tümörlerinde Minimal İnvaziv Tedavi: Radyofrekans Ablasyon İlk Deneyimlerimiz

Yıl 2014, Cilt: 15 Sayı: 2, 116 - 123, 01.08.2014

Mehmet Bilgehan Yüksel Bilal Gümüş Erdem Özbek Ayhan Karaköse Serdar Tarhan Gökhan Temeltaş Talha Müezzinoğlu

Öz

Objective: In this study, we aimed to present our initial results in radiofrequency ablation of kidney tumors (RFTA). Material and Methods: In 2011-2012, the data of 5 patients who underwent RFTA were evaluated. The RFTA applications were performed by ultrasound guided percutaneous technique (USG-RFTA) in 4 patients and by retroperitoneally laparoscopic technique in 1 under general anesthesia. Previously, a routine renal mass biopsy was applied. Patients were radiologically controlled at 1., 3., 6., 12. months and then annually. The presence of viable tumor at 1st month was accepted as the residue and at subsequent controls after 1st was accepted as recurrence. The presence of residual tumor at 1st control was evaluated as the failure. Results: The mean age was 65.2 ±10.2 years and the mean tumor size was 27.6±4.34 mm. 3 apllicaitons were left-sided and 2 were right-sided. One of right-sided aplication was performed in a partially nephrectomized solitary kidney. All biopsies demonstrated renal cell carcinoma. The presence of residue at 1st month control (the failure) was determined in 2(40%) USG-RFTA cases. The success rate was estimated as 60%. USG-RFTA repeated in the failed cases. Subsequently, one was controlled at 1st month and no residual tumor was determined . The other was not evaluated yet. The mean follow-up duration without any recurrence was 11.4±6.65 months. No complication related to the application was occurred. Conclusion: The RFTA application seems to be safe, less invasive and effective treatment modality in selected cases of renal tumors

Anahtar Kelimeler

Kidney tumor; radiofrequency ablation; ultrasound; laparoscopy

Böbrek Tümörlerinde Minimal İnvaziv Tedavi: Radyofrekans Ablasyon İlk Deneyimlerimiz

Öz

Amaç: Bu çalışmada böbrek tümörü tanısıyla yaptığımız radyofrekans tümör ablasyonu (RFTA) uygulamasındaki ilk deneyimlerimizi sunmayı amaçladık. Gereç ve Yöntem: 2011-2012 yıllarında böbrek tümörü tanısıyla RFTA yapılan 5 hastanın verileri değerlendirildi. RFTA işlemi, 4 hastada ultrason klavuzluğunda (USG-RFTA) ve 1 hastada retroperitoneal teknikle laparoskopi eşliğinde (L-RFTA) genel anestezi altında gerçekleştirildi. RFTA öncesi rutin renal kitle biyopsisi yapıldı. Hastalar işlem sonrası 1, 3, 6 ve 12. aylarda ve sonrasında yılda bir kontrastlı radyolojik görüntüleme teknikleri ile kontrol edildi. 1. ay kontrolde canlı tümör dokusu varlığı rezidü ve ilk ay kontrolü normal olup sonraki aylarda saptanan canlı (kontrastlanan) tümör dokusu nüks olarak değerlendirildi. 1. ay kontrolde rezidü varlığı da başarısızlık olarak kabul edildi. Bulgular: Ortalama yaş 65,2 ±10,2 yıl ve ortalama tümör boyutu 27,6±4,34 mm bulundu. İşlemlerin 3’ü sol ve 2’si sağ tarafa uygulanmıştır. Sağ taraf işlemlerinden biri sağ parsiyel nefrektomili soliter böbreğe yapılmıştır. Tüm biyopsi patolojileri renal hücreli kanser olarak bulundu. İki (%40) USG-RFTA olgusunda 1. ay kontrolde rezidü varlığı (başarısızlık) gözlendi. İşlem başarısı %60 olarak belirlendi. Başarısızlık gözlenen 2 olguya USG-RFTA tekrarı yapıldı. Takiben kontrolü yapılan 1 olgunun ilk ay kontrolünde rezidü saptanmazken, diğer olgunun kontrolü henüz yapılmamıştır. Ortalama takip süresi 11,4±6,65 ay olup, bu süre içinde hiçbir olguda nüks gözlenmemiştir. Hiçbir hastada uygulamaya bağlı komplikasyon gözlenmemiştir. Sonuç: RTFA işlemi seçilmiş böbrek tümörlerinin tedavisinde güvenli, daha az invaziv ve etkili bir tedavi yöntemi olarak görünmektedir

Anahtar Kelimeler

Böbrek tümörü; radyofrekans ablasyon; ultrason; laparoskopi

Kaynakça

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