中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Issue 7
Jul.  2018
Turn off MathJax
Article Contents

Clinical effect of selective transcatheter arterial embolization combined with CT-guided microwave ablation in treatment of hepatic hemangioma

DOI: 10.3969/j.issn.1001-5256.2018.07.018
  • Received Date: 2018-01-02
  • Published Date: 2018-07-20
  • Objective To investigate the clinical effect and safety of selective transcatheter arterial embolization ( TAE) combined with CT-guided microwave ablation in the treatment of hepatic hemangioma, and to provide a reference for the selection of treatment methods for hepatic hemangioma. Methods A retrospective analysis was performed for the clinical data of 29 patients with hepatic hemangioma who underwent selective TAE combined with CT-guided microwave ablation in Beijing You An hospital from January 2012 to December 2016. The complications of ablation, complete ablation rate, change in the size of hemangioma, and improvement in clinical symptoms were observed to evaluate the clinical effect and safety of this treatment regimen. The t-test was used for the comparison of continuous data between groups.Results A total of 29 patients with 31 lesions of hepatic hemangioma were treated. Eleven patients experienced the complications of ablation, among whom two experienced pyrexia alone, three experienced abdominal pain, two experienced pyrexia and abdominal pain, two experienced hemoglobinuria alone, one experienced hemoglobinuria and slight subcapsular bleeding, and one experienced bile tumor and abdominal pain, and these patients were cured after symptomatic treatment. The incidence rate of complications was 37. 93% ( 11/29) , and no patient experienced severe complications or death. The patients were followed up till three months after surgery, and the clinical symptoms completely disappeared after ablation. According to the results of contrast-enhanced computed tomography or magnetic resonance imaging, there was a significant reduction in the mean diameter of the 31 hepatic hemangiomas after surgery ( 4. 44 ± 1. 39 cm vs 6. 58 ± 1. 25 cm, t =14. 02, P < 0. 01) , and the mean residual rate of the lesions of hepatic hemangioma was ( 66. 6 ± 12. 5) %. Of all patients, 27 ( 93. 1%) achieved complete ablation and 2 ( 6. 9%) had incomplete ablation, and since these two patients had complete remission of clinical symptoms and follow-up at 6 months after surgery showed no progressive enlargement of hepatic hemangioma, ablation was not performed again. Conclusion Selective TAE combined with CT-guided microwave ablation has a good clinical effect and high safety in the treatment of hepatic hemangioma, and therefore, it is a minimally invasive surgery holding promise for clinical application.

     

  • loading
  • [1] BAJENARU N, BALABAN V, SAVULESCU F, et al.Hepatic hemangioma review[J].J Med Life, 2015, 8 (Spec Issue) :4-11.
    [2]YOON SS, CHARNY CK, FONG Y, et al.Diagnosis, management, and outcomes of 115 patients with hepatic hemangioma[J].Jam Coll Surg, 2003, 197 (3) :392-402.
    [3] ERDOGAN D, BUSCH OR, van DELDEN OM, et al.Management of liver hemangiomas according to size and symptoms[J].J Gastroenterol Hepatol, 2007, 22 (11) :1953-1958.
    [4] TERKIVATAN T, VRIJLAND WW, DEN HOED PT, et al.Size oflesion is not a criterion for resection during management of giant liver haemangioma[J].Br J Surg, 2002, 89 (10) :1240-1244.
    [5]HERMAN P, COSTA ML, MACHADO MA, et al.Management of hepatic hemangiomas:A 14-year experience[J].J Gastrointest Surg, 2005, 9 (6) :853-859.
    [6]SRIVATAVA DN, GANDHI D, SEITH A, et al.Transcatheter arterial embolization in the treatment of symptomatic cavernous hemangiomas of the liver:A prospective study[J].Abdom Imaging, 2001, 26 (5) :510-514.
    [7]TANG XY, WANG Z, WANG T, et al.Efficacy, safety and feasibility of ultrasound-guided percutaneous microwave ablation for large hepatic hemangioma[J].J Dig Dis, 2015, 16:525-530.
    [8]LI JJ, ZHENG JS, CUI XW, et al.CT-guided radiofrequency ablation of hepatic tumor:An analysis of complications[J].J Intervent Radiol, 2009, 18 (5) :367-369. (in Chinese) 李建军, 郑加生, 崔雄伟, 等.CT引导下肝肿瘤射频消融治疗的并发症分析[J].介入放射学杂志, 2009, 18 (5) :367-369.
    [9]GAO J, FAN RF, YANG JY, et al.Radiofrequency ablation in the treatment of hepatic hemangiomas-consensus of experts in China[J].J Clin Hepatol, 2017, 33 (9) :1638-1645. (in Chinese) 高君, 范瑞芳, 杨家印, 等.肝血管瘤射频消融治疗 (国内) 专家共识[J].临床肝胆病杂志, 2017, 33 (9) :1638-1645.
    [10]DINDO D, DEMARTINES N, CLAVIEN PA.Classification of surgical complications:A new proposal with evaluation in a cohort of6336 patients and results of a survey[J].Ann Surg, 2004, 240 (2) :205-213.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Article Metrics

    Article views (1634) PDF downloads(312) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return