标准与讨论
ENGLISH ABSTRACT
肾肿瘤冷冻消融围手术期管理中国专家共识2022版
司同国
李龙
郭志
徐斌
代表中国抗癌协会肿瘤介入与微创诊疗继续教育基地
作者及单位信息
·
DOI: 10.3760/cma.j.cn112138-20221024-00780
Chinese expert consensus on perioperative management of renal tumor cryoablation (2022 edition)
Si Tongguo
Li Long
Guo Zhi
Xu Bin
on behalf of Tumor Intervention and Minimally Invasive Diagnosis and Treatment Continuing Education Base, China Anti-Cancer Association
Authors Info & Affiliations
Si Tongguo
Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
Li Long
Department of Urology, Shanghai Ninth People′s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China
Guo Zhi
Department of Interventional Therapy, Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China
Xu Bin
Department of Urology, Shanghai Ninth People′s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China
on behalf of Tumor Intervention and Minimally Invasive Diagnosis and Treatment Continuing Education Base, China Anti-Cancer Association
·
DOI: 10.3760/cma.j.cn112138-20221024-00780
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摘要

近几年来,肾癌发病率呈持续增长趋势,传统上外科切除是治疗小肾癌的“金标准”,然而对于预期寿命较短,伴有其他合并症及肾功能受损不适合手术的患者,肾癌局部消融治疗无疑是最好的选择。近年来随着消融技术的进步和长时间的疗效随访,局部消融治疗已经取得了很好的治疗效果。由于国内许多医院都在开展或拟开展肾肿瘤冷冻消融,为提高肾肿瘤冷冻消融临床治愈率及手术安全性,需要对消融的手术适应证、禁忌证、围手术期处理、疗效评价等常见问题进行规范。在国内目前尚无肾肿瘤冷冻消融围手术期专家共识形成,为规范临床工作中肾肿瘤冷冻消融围手术期管理及相关的技术操作,提升冷冻消融的有效性和安全性,中国抗癌协会肿瘤介入与微创诊疗继续教育基地专家委员会召集相关领域专家探讨制订本共识,供临床参考应用。

冷冻疗法;肾肿瘤;腹腔镜
ABSTRACT

In recent years, the incidence of renal cancer has been increasing continuously. Surgical resection is the “gold standard” for the treatment of small renal cancer. However, local ablation therapy of renal cancer is undoubtedly the best choice for patients with short life expectancy, other complications, and impaired renal function who are not suitable for surgery. In recent years, with the development of ablation techniques and long-term follow-up, local ablation has shown good therapeutic effects. As many domestic hospitals are performing or planning to perform renal tumor cryoablation to improve the clinical cure rate and surgical safety of renal tumor cryoablation, it is necessary to standardize the surgical indications, contraindications, perioperative management, efficacy evaluation, and other common problems. Currently, there is no expert consensus regarding perioperative renal tumor cryoablation in China. To standardize the perioperative management of renal tumor cryoablation and related technical operations in clinical practice, and improve the effectiveness and safety of cryoablation, the expert committee of Tumor Interventional and Minimally Invasive Diagnosis and Treatment Continuing Education Base of the Chinese Anti-Cancer Association convened experts in related fields to discuss and formulate this consensus, which is hereby published, for clinical reference and application.

Cryotherapy;Kidney neoplasms;Laparoscopes
Xu Bin, Email: mocdef.aabnis4002bxhc
Guo Zhi, Email: mocdef.3ab61.pivihzoug.rjc
引用本文

司同国,李龙,郭志,等. 肾肿瘤冷冻消融围手术期管理中国专家共识2022版[J]. 中华内科杂志,2023,62(04):363-368.

DOI:10.3760/cma.j.cn112138-20221024-00780

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肾细胞癌(renal cell carcinoma,RCC)简称肾癌,是起源于肾小管上皮的恶性肿瘤,占肾脏恶性肿瘤的80%~90% 1 , 2。肾癌的组织病理类型最常见为透明细胞癌,其次为乳头状肾细胞癌和嫌色细胞癌,以及集合管癌等少见类型的肾细胞癌 2 , 3 , 4。肾癌发病率仅次于前列腺癌及膀胱癌,占泌尿系统肿瘤第3位。在世界范围内,肾癌的发病率约占成人恶性肿瘤的3%,其分布具有明显的地域差异,北美、西欧等西方发达国家发病率最高,而非洲及亚洲等发展中国家发病率最低 5。全世界范围内,肾癌发病目前排在男性恶性肿瘤第9位(21.4万例新患者)及女性第14位(12.4万例新患者),其男女发病率约为2∶1,发病高峰在60~70岁。目前肾癌病因尚不明确,其发病与遗传、吸烟、肥胖、高血压及抗高血压药物等有关 6。近几十年来,吸烟和肥胖人群增加迅猛,被公认为致肾癌首要危险因素,流行病学调查显示在大多数国家和地区,肾癌发病率呈持续增长趋势。中国肿瘤登记年报显示,1988—2015年,我国肾癌发病率呈上升趋势,人口结构老龄化、生活方式西方化及早期筛查的推广可能是发病率增高的原因 7
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备注信息
A
徐斌,Email: mocdef.aabnis4002bxhc
B
郭志,Email: mocdef.3ab61.pivihzoug.rjc
C
司同国, 李龙, 郭志, 等. 肾肿瘤冷冻消融围手术期管理中国专家共识2022版[J]. 中华内科杂志, 2023, 62(4): 363-368. DOI: 10.3760/cma.j.cn112138-20221024-00780.
D
所有作者声明无利益冲突
E
上海市科委“科技创新行动计划”技术标准项目 (19DZ2204000)
上海交通大学医学院附属第九人民医院“交叉”基金 (JYJC201804)
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