RESUMO
AIM: To analyse the technical success of ablation therapy and the incidence of complications in patients treated with pulmonary ablation and to assess factors affecting local disease control and patient survival in a subgroup with metastatic colorectal cancer. MATERIALS AND METHODS: Technical success and complications in all patients undergoing lung ablation between June 2009 and July 2015 were recorded. Overall survival and local disease control in a subgroup with metastases from a colorectal primary were calculated. Factors influencing outcome were explored. RESULTS: Two hundred and seven pulmonary ablations were performed in 86 patients at 156 attendances. Technical success was achieved in 207/207 (100%). Thirty and 90-day mortality was 0%. The major complication rate was 13/86 (15%). One hundred and one metastases were treated in 46 patients with a colorectal primary. This group had a mean ± standard error survival time of 53.58±3.47 months with a 1, 2, 3, 4, and 5-year survival rate of 97.4%, 91.3%, 81.5%, 59.8%, and 48%. There was no statistically significant difference in survival regarding time to development of metastatic disease, the total number of lesions ablated, the initial number of lesions ablated, the maximum size of lesion treated, or unilateral versus bilateral disease. Patients with extrapulmonary disease were found to have a shorter survival from the primary diagnosis. Seventy-eight (77.2%) of the 101 lesions were stable after first RFA. Local relapse was more likely when a metastasis was close to a large (>3 mm) vessel. CONCLUSION: RFA is a safe and effective procedure that can be performed without on-site cardiothoracic support. Good outcomes depend upon careful patient selection. This study supports its use in oligometastatic disease.
Assuntos
Ablação por Cateter/mortalidade , Hospitais de Distrito/estatística & dados numéricos , Hospitais Gerais/estatística & dados numéricos , Neoplasias Pulmonares/cirurgia , Complicações Pós-Operatórias/mortalidade , Procedimentos Cirúrgicos Pulmonares/mortalidade , Idoso , Idoso de 80 Anos ou mais , Ablação por Cateter/estatística & dados numéricos , Humanos , Neoplasias Pulmonares/mortalidade , Pessoa de Meia-Idade , Segurança do Paciente , Procedimentos Cirúrgicos Pulmonares/estatística & dados numéricos , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida , Resultado do Tratamento , Reino Unido/epidemiologiaRESUMO
The fatiguing effect of a series of isometric tetani and of tetani with shortening and maximum power output were compared using soleus and extensor digitorum longus muscle of mouse. Mean force in test isometric tetani after the series was reduced by up to 35% compared with pre-series controls. Tetani with shortening were always more fatiguing than isometric tetani.
