改良腹腔镜下射频消融术治疗巨大肝血管瘤21例

The clinical applications of modified laparoscopic radiofrequency ablation in the treatment of hepatic cavernous hemangioma

目的探讨改良的腹腔镜下射频消融术(RFA)治疗巨大肝脏血管瘤的可行性及疗效。方法回顾性分析2014年6月至2016年6月改良的腹腔镜下RFA治疗21例患者的24个巨大肝血管瘤病灶。应用SPSS19.0统计学软件分析,术后1、6个月瘤体平均直径、RFA时间、平均住院时间以x珋±s表示,采用t检验,P<0.05差异有统计学意义。结果 24个巨大肝血管瘤病灶均在腹腔镜下顺利完成手术。术中未肝门阻断,平均射频消融时间(8±4.6)min,术中平均出血量(10±5.6)ml。术后平均住院时间为(8.5±3.6)d,术后无胆瘘、出血及其他严重并发症。术后1个月复查超声造影,瘤体平均直径(3.5±1.6)cm,18个血管瘤病灶完全无残留血液供应,6个病灶少许残留血液供应,分别位于肝Ⅶ3个及肝Ⅷ3个。术后6个月复查超声造影,瘤体直径及血流情况同术后1个月复查结果。结论改良的腹腔镜下RFA治疗巨大肝血管瘤安全可行,疗效满意。

Objectives To evaluate the feasibility and efficacy of modified laparoscopic radiofrequency ablation on the treatment of hepatic cavernous hemangioma. Methods A retrospective cohort study was adopted. We analyzed clinical data of 21 cases with 24 liver lesions of hepatic cavernous hemangioma who were treated with modified laparoscopic radiofrequeney ablation from June 2014 to June 2016. The diameter of the lesions at postoperative 1 and 6 months, the average radiofrequency ablation time, and the average hospitalization time were presented as x ± s. SPSS19.0 was used for statistical analysis. The clinical data of before and after surgery were compared by t test. P 〈 0.05 was considered to be of statistically significant difference. Results All 24 liver lesions were successfully treated with modified laparoscopic radiofrequeney ablation. During the operation, there was no hepatic inflow occlusion, and the average radiofrequeney ablation time was （8 ± 4.6） rain, with a mean volume of intraoperative blood loss of （10 ± 5.6） ml. The average postoperative hospitalization time was （ 8.5 ± 3.6） d. There were no biliary fistula, hemorrhage and other serious complications after operation. All the patients were followed up with B-contrast-enhanced uhrasoundat at the time point of postoperative 1 and 6 months. The average diameter of lesions at postoperative 1 month was （3.5 ± 1.6） cm with 18 lesions completely lack of residual blood supply, and with 6 lesions partially lack of blood supply located at Ⅶ 3 and Ⅷ3. Similar results were identified at postoperative 6 months. Conclusion Modified laparoscopie radiofrequency ablation is a feasible, safe and effective treatment for hepatic cavernous hemangioma.