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首页> 美国卫生研究院文献>other >Percutaneous Intraductal Radiofrequency Ablation Combined with Biliary Stent Placement for Nonresectable Malignant Biliary Obstruction Improves Stent Patency but not Survival
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Percutaneous Intraductal Radiofrequency Ablation Combined with Biliary Stent Placement for Nonresectable Malignant Biliary Obstruction Improves Stent Patency but not Survival

机译：经皮导管内射频消融结合胆道支架置入术治疗不可切除的恶性胆道梗阻改善了支架通畅性但未改善生存率

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Although radiofrequency (RF) ablation has been accepted as a curative treatment modality for solid organ tumors, intraductal RF ablation for malignant biliary obstruction has not been widely described.The aim of this study was to evaluate the feasibility, safety, and efficacy (in terms of stent patency and survival) of intraductal RF ablation combined with biliary stent placement for nonresectable malignant biliary obstruction.A search of the nonresectable malignant extrahepatic biliary obstruction database (179 patients) identified 18 consecutive patients who were treated with biliary intraluminal RF ablation during percutaneous transhepatic cholangiodrainage and inner stent placement (RF ablation group) and 18 patients who underwent inner stent placement without biliary intraluminal RF ablation (control group). The patients were matched for tumor type, location of obstruction, tumor stage, and Child–Pugh class status. Primary endpoints included safety, stent patency time, and survival rates. The secondary endpoint was effectiveness of the technique.The RF ablation and control groups were closely matched in terms of age, diagnosis, presence of metastases, presence of locally advanced tumor, American Society of Anesthesiologists (ASA) grade, and chemotherapy regimen (all P > 0.05). The technical success rate for both groups was 100%. The median time of stent patency in the RF ablation and control groups were 5.8 (2.8–11.5) months and 4.5 (2.4–8.0) months, respectively (Kaplan–Meier analysis: P = 0.03). The median survival times in the RF ablation and control groups were 6.1 (4.8–15.2) months and 5.8 (4.2–16.5) months, with no significant difference according to Kaplan–Meier analysis (P = 0.45). In univariate and multivariate analyses, poorer overall survival was associated with advanced age and presence of metastases (P < 0.05).Intraductal RF ablation combined with biliary stent placement for nonresectable malignant biliary obstruction is safe and feasible and effectively increases stent patency time. However, it does not improve patient survival.
机译：尽管射频（RF）消融已被接受作为治疗实体器官肿瘤的方法，但导管内射频消融治疗恶性胆道梗阻的方法尚未得到广泛描述。本研究的目的是评估可行性，安全性和有效性（以术语导管内射频消融联合胆道内支架置入术治疗不可切除的恶性胆道梗阻的研究。通过对不可切除的恶性肝外胆道梗阻数据库（179例患者）的搜索，确定了18例经皮肝穿刺术中接受了腔内射频消融的连续患者胆管引流和内支架置入（RF消融组）和18例未行胆管腔内射频消融的内支架置入患者（对照组）。根据肿瘤类型，梗阻部位，肿瘤分期和Child–Pugh等级状态对患者进行匹配。主要终点包括安全性，支架通畅时间和生存率。次要终点是该技术的有效性。射频消融和对照组在年龄，诊断，转移灶的存在，局部晚期肿瘤的存在，美国麻醉医师学会（ASA）等级和化疗方案方面密切相关（所有P > 0 .05）。两组的技术成功率均为100％。 RF消融组和对照组的支架通畅时间中位数分别为5.8（2.8-11.5）个月和4.5（2.4-8.0）个月（Kaplan–Meier分析：P = 0 .03） 。 RF消融组和对照组的中位生存时间分别为6.1（4.8-15.2）个月和5.8（4.2-16.5）个月，根据Kaplan-Meier分析，差异无统计学意义（P = 0 。 45）。在单因素和多因素分析中，较差的总体生存率与高龄和转移的发生有关（P kbd> 0 .05）。并有效地增加了支架的通畅时间。但是，它不能提高患者的生存率。

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