Efficacy of laparoscopic ultrasound-guided microwave ablation for giant hepatic hemangioma

doi:10.3877/cma.j.issn.2095-3232.2020.04.009

Abstract

Abstract:

Objective

To explore the efficacy of laparoscopic ultrasound-guided microwave ablation in the treatment of giant hepatic hemangioma.

Methods

Clinical data of 72 patients with giant hepatic hemangioma who admitted in the Second Affiliated Hospital of Air Force Medical University from January 2016 to June 2018 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 32 patients were male and 40 female, with a mean age of (50±13) years old. Patients were assigned to laparoscopic ultrasound-guided microwave ablation group (microwave group, n=36) and laparoscopic resection of hepatic hemangioma group (resection group, n=36) according to different operations. The perioperative situation and complications between two groups were compared and the efficacy was evaluated. Measurement data such as age and maximum diameter of hemangioma were compared using t test. Incidence of complication, remission rates, etc. were compared using Chi-square test or Fisher's exact probability.

Results

The duration of operation, time to postoperative drainage tube extraction, and length of postoperative hospital stay in microwave group were (76±25) min, (3.2±0.8) d, and (4.7±0.9) d, respectively, significantly lower than (138±27) min, (4.5±1.0) d, and (6.0±1.1) d in resection group (t=-6.494, -3.045, -3.262; P<0.05). At postoperative 3 d, ALB in microwave group was (36.1±1.7) g/L, which was significantly higher than (34.7±1.6) g/L in resection group (t=2.852, P<0.05). The prothrombin time in microwave group was (11.5±1.1) s, which was significantly lower than (12.9±1.8) s in resection group (t=-2.522, P<0.05). In microwave group, no intra-abdominal hemorrhage, no bile leakage and 5 cases of hemoglobinuria were observed, and in resection group, it was accordingly 4, 4, 0 cases, where significant differences were observed (P<0.05). The overall remission rate at 12 months postoperatively was 89% (32/36) in microwave group and 81% (29/36) in resection group, which did not significantly differed between two groups (χ²=0.966, P>0.05).

Conclusions

Laparoscopic ultrasound-guided microwave ablation exert significant effect for giant hepatic hemangioma with advantages of safety and minimal invasion.

Key words: Laparoscopes, Ultrasonography, interventional, Catheter ablation, Hemangioma, Hepatectomy

Yafeng Chen, Xilin Du, Rui Dong, Jianguo Lu, Li Zang. Efficacy of laparoscopic ultrasound-guided microwave ablation for giant hepatic hemangioma[J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2020, 09(04): 333-338.

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References 22

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组别	例数	性别（例）		年龄（岁，±s ）	BMI （kg/m²，±s ）	血管瘤最大径（cm，±s ）	肝功能Child-Pugh分级（例）		ICGR15[M （Q_R）]
组别	例数	男	女	年龄（岁，±s ）	BMI （kg/m²，±s ）	血管瘤最大径（cm，±s ）	A级	B级	ICGR15[M （Q_R）]
微波组	36	13	23	51±15	21.8±2.7	12.5±1.6	28	8	0.06(0.01, 0.25)
切除组	36	16	20	48±12	20.9±1.8	11.7±1.2	32	4	0.05(0.01, 0.16)
统计值	?	χ²=0.520		t=0.740	t=1.711	t=1.333	χ²=0.600		Z=1.604
P值	?	0. 471		0.475	0.109	0.209	0.206		0.109

组别	例数	性别（例）		年龄（岁，±s ）	BMI （kg/m²，±s ）	血管瘤最大径（cm，±s ）	肝功能Child-Pugh分级（例）		ICGR15[M （Q_R）]
组别	例数	男	女	年龄（岁，±s ）	BMI （kg/m²，±s ）	血管瘤最大径（cm，±s ）	A级	B级	ICGR15[M （Q_R）]
微波组	36	13	23	51±15	21.8±2.7	12.5±1.6	28	8	0.06(0.01, 0.25)
切除组	36	16	20	48±12	20.9±1.8	11.7±1.2	32	4	0.05(0.01, 0.16)
统计值	?	χ²=0.520		t=0.740	t=1.711	t=1.333	χ²=0.600		Z=1.604
P值	?	0. 471		0.475	0.109	0.209	0.206		0.109

组别	手术时间（min，±s ）	术中出血量[ml，M（Q_R）]	术中输血量[ml，M（Q_R）]	术后恢复进食时间（d，±s ）	术后引流管拔除时间（d，±s ）	术后住院时间（d，±s ）
微波组	76±25	070（30，250）	000（0，0）	2.1±0.6	3.2±0.8	4.7±0.9
切除组	138±27	450（100, 1 000）	200（0, 600）	3.0±0.8	4.5±1.0	6.0±1.1
统计值	t=-6.494	Z=-3.297	Z=-2.692	t=-3.210	t=-3.045	t=-3.262
P值	0.000	0.001	0.007	0.009	0.011	0.006

组别	手术时间（min，±s ）	术中出血量[ml，M（Q_R）]	术中输血量[ml，M（Q_R）]	术后恢复进食时间（d，±s ）	术后引流管拔除时间（d，±s ）	术后住院时间（d，±s ）
微波组	76±25	070（30，250）	000（0，0）	2.1±0.6	3.2±0.8	4.7±0.9
切除组	138±27	450（100, 1 000）	200（0, 600）	3.0±0.8	4.5±1.0	6.0±1.1
统计值	t=-6.494	Z=-3.297	Z=-2.692	t=-3.210	t=-3.045	t=-3.262
P值	0.000	0.001	0.007	0.009	0.011	0.006

组别	ALB（g/L，±s ）	ALT[U/L，M（Q_R）]	TB（μmol/L，±s ）	PT（s，±s ）
微波组	36.1±1.7	125（52, 312）	35±10	11.5±1.1
切除组	34.7±1.6	140（78, 440）	38±12	12.9±1.8
统计值	t=2.852	Z=-1.015	t=-1.704	t=-2.522
P值	0.017	0.310	0.110	0.030

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