Local anesthesia for percutaneous US/CT-guided bipolar radiofrequency ablation of small renal masses: A safe and feasible alternative

Sun, Yifan; Wang, Wei; Zhang, Qing; Zhao, Xiaozhi; Zhu, Guanchen; Hao, Jiange; Kan, Yi; H, Guo

doi:10.1016/j.urolonc.2021.04.006

Cited by 3 publications

(3 citation statements)

References 19 publications

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“…The RFA can be performed under local anesthesia (LA), conscious sedation (CS), or general anesthesia (GA) 36,37 . All cases in the RFA group underwent anesthesia assessment prior to surgery and received general anesthesia.…”

Section: Discussionmentioning

confidence: 99%

“…All cases in the RFA group underwent anesthesia assessment prior to surgery and received general anesthesia. The putative advantages are as follows: (1) general anesthesia facilitates intraoperative respiratory dynamic regulation of the patient, enforced Valsalva maneuver, and extended apnea, enhancing tumor precision and targeting, particularly in the upper pole region, while concurrently minimizing collateral harm 34 ; (2) enhanced patient safety and comfort are achieved through dedicated vigilance and hemodynamic and pain management by anesthesiologists 37 ; (3) studies across multiple series of percutaneous ablation for stage T1a RCC have consistently demonstrated the highest rate of surgical tumor control under general anesthesia 36,37 . Insu cient pain control (e.g., LA) may lead the radiologist to hasten or discontinue the RFA procedures, potentially culminating in an incomplete ablation.…”

Section: Discussionmentioning

confidence: 99%

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Real-Time Contrast-Enhanced Ultrasound Combined with Ultrasound Monitoring Radiofrequency Ablation Versus Laparoscopic Partial Nephrectomy for cT1a Renal Cell Carcinoma: A Comparative Study with Mid-Term Follow-Up

Chen,

Fan,

Sun

et al. 2024

Preprint

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Objective The study aims to compare oncological and functional mid-term outcomes following real-time contrast-enhanced ultrasound combined with ultrasound monitoring radiofrequency ablation (CEUS/USM-RFA) versus laparoscopic partial nephrectomy (LPN) for treating cT1a renal cell carcinoma (RCC). Methods This is a retrospective data analysis of a high-volume single tertiary center. Patients with cT1a RCC were treated with CEUS/USM-RFA or LPN following multidisciplinary decision-making. According to different surgical methods, patients were divided into the RFA and LPN groups. Demographic information, tumor characteristics, surgical data, complications, and functional and oncological outcomes were reviewed. Differences between categorical and continuous parameters were evaluated using Pearson's chi-square and Student's t-tests, respectively. Results According to different surgical methods, 164 patients were divided into the RFA (41 cases) and LPN (123 cases) groups. The results revealed a nonsignificant difference in gender, tumor side, tumor size, RCC type, R.E.N.A.L. score, major complications, technical success, technique efficacy, or local tumor progression (LTP) between the two groups (p > 0.05). However, significant differences were observed in age, Eastern Cooperative Oncology Group (ECOG) score, Charlson Comorbidity Index (CCI) score, American Society of Anesthesiologist (ASA) score, tumor location, and minor complications (p < 0.05). The operative time, estimated blood loss, hospitalization time, and estimated glomerular filtration rate (eGFR) loss of the affected kidney in the RFA group were less than in the LPN group (p < 0.05). The decline of post-procedure eGFR of the affected kidney at six months was significantly less in RFA than in the LPN group (1.39 ± 4.67 vs. 4.32 ± 4.00 mL/min/1.73 m2, p < 0.001). Nevertheless, both groups had a similar 2-year recurrence-free survival (RFS) rate (97.65% vs. 100%, p = 0.083). Conclusion The CEUS/USM-RFA and LPN for cT1a RCC were all safe and effective. In rigorously screened patients with cT1a RCC, CEUS/USM-RFA had comparable oncological outcomes with LPN. The CEUS/USM-RFA had superiority in perioperative outcomes and preserving renal function.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Real-Time Contrast-Enhanced Ultrasound Combined with Ultrasound Monitoring Radiofrequency Ablation Versus Laparoscopic Partial Nephrectomy for cT1a Renal Cell Carcinoma: A Comparative Study with Mid-Term Follow-Up

Chen,

Fan,

Sun

et al. 2024

Preprint

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“…The results show that the success rate of surgery is higher in patients with the CT examination than in those without [ 19 ]. Sun et al [ 20 ] found that imaging technology was an effective and tolerable method for the guidance of local anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Spiral Computed Tomography Imaging Analysis of Positioning of Lumbar Spinal Nerve Anesthesia under the Concept of Enhanced Recovery after Surgery

Feng

Zhao

Wang³

2022

Contrast Media & Molecular Imaging

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The objective of this research was to explore the effect of perioperative anesthesia management for patients based on the concept of enhanced recovery after surgery (ERAS) and the application value of the computed tomography (CT) localization method in lumbar spinal nerve anesthesia, reducing the damage caused by anesthesia. One hundred and twenty patients who underwent the lumbar spinal anesthesia in lower limb surgery were selected as the research subjects. According to puncture positioning and nursing intention, the patients were classified into the control group with 30 patients (method of anatomical landmarks), CT group with 50 patients (the CT localization), and ERAS group with 40 patients (the CT localization and the ERAS management). The effects of the anesthesia positioning method and the ERAS management were compared and analyzed. The results showed that d (0.32) and r (0.27) of exponential filtering function were notably smaller than those of R-L filtering function (d = 0.40, r = 0.39) and of S-R filtering function (d = 0.37, r = 0.36) ( P < 0.05 ). Puncture time ((9.23 ± 0.32) min vs. (13.11 ± 0.45) min), puncture direction change (20% vs. 33.33%), abnormal puncture sensation (22% vs. 40%), and nerve root touch (4% vs. 23.33%) in the CT group were all lower than those in the control group. The proportion of Degree I anesthesia effect (94%) of the CT group was greatly higher than that of the control group (76.67%) ( P < 0.05 ). The VAS score, time of activity and gastrointestinal function recovery, and the incidence of adverse reactions (2.5% vs. 28%) in the ERAS group were lower than those in the CT group ( P < 0.05 ). All in all, the CT localization method can improve the difficulty of anesthesia puncture and improve the anesthetic effect; the ERAS nursing concept can improve the postoperative pain of patients and contribute to the prognosis of patients and have a good clinical value.

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RETRACTED: Meta analysis of clinical prognosis of radiofrequency ablation versus partial nephrectomy in the treatment of early renal cell carcinoma

Wang

2023

Front. Oncol.

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ObjectiveTo systematically review the differences between radiofrequency ablation and partial nephrectomy in patients with early-stage renal cell carcinoma, and to provide evidence-based medical evidence for the choice of surgery for patients with early-stage renal cell carcinoma.MethodsAccording to the search strategy recommended by the Cochrane Collaboration, Chinese databases such as CNKI, VIP Chinese Science and Technology Periodicals Database (VIP), and Wanfang Full-text Database were searched with Chinese search terms. And PubMed and MEDLINE as databases for English literature retrieval. Retrieve the relevant literature on renal cell carcinoma surgical methods published before May 2022, and further screen radiofrequency ablation and partial nephrectomy in patients with renal cell carcinoma The relevant literature on the application is analyzed. RevMan5.3 software was used for heterogeneity test and combined statistical analysis, sensitivity analysis, and subgroup analysis. Analysis, and draw forest plot, using Stata software Begger quantitative assessment of publication bias.ResultsA total of 11 articles were involved, including 2958 patients. According to the Jadad scale, 2 articles were of low quality, and the remaining 9 articles were of high quality. Results of this study demonstrates the advantages of radiofrequency ablation in early-stage renal cell carcinoma. The results of this meta-analysis showed that compared with partial nephrectomy, there was significant difference in the 5-year overall survival rate between radiofrequency ablation and partial nephrectomy and there was a statistically significant difference between the two surgical methods in the 5-year relapse free survival rate of early renal cell carcinoma.Conclusion1. Compared with partial nephrectomy, the 5-year relapse-free survival rate, the 5-year cancer specific survival rate and the overall 5-year survival rate were higher in the radiofrequency ablation group. 2. Compared with partial nephrectomy, there was no significant difference in the postoperative local tumor recurrence rate of radiofrequency ablation. 3. Compared with partial resection, radiofrequency ablation is more beneficial to patients with renal cell carcinoma.

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Local anesthesia for percutaneous US/CT-guided bipolar radiofrequency ablation of small renal masses: A safe and feasible alternative

Cited by 3 publications

References 19 publications

Real-Time Contrast-Enhanced Ultrasound Combined with Ultrasound Monitoring Radiofrequency Ablation Versus Laparoscopic Partial Nephrectomy for cT1a Renal Cell Carcinoma: A Comparative Study with Mid-Term Follow-Up

Real-Time Contrast-Enhanced Ultrasound Combined with Ultrasound Monitoring Radiofrequency Ablation Versus Laparoscopic Partial Nephrectomy for cT1a Renal Cell Carcinoma: A Comparative Study with Mid-Term Follow-Up

Spiral Computed Tomography Imaging Analysis of Positioning of Lumbar Spinal Nerve Anesthesia under the Concept of Enhanced Recovery after Surgery

RETRACTED: Meta analysis of clinical prognosis of radiofrequency ablation versus partial nephrectomy in the treatment of early renal cell carcinoma

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