腹腔镜下微波消融治疗巨大肝血管瘤:附86例报告

Laparoscopic microwave ablation for giant hepatic hemangioma:a report of 86 cases

目的:探讨应用腹腔镜微波消融治疗巨大肝血管瘤的疗效和技术要点。方法:回顾性分析2015年1月—2015年12月采用腹腔镜微波消融治疗86例直径>5 cm的肝血管瘤患者的临床资料。结果:86例均手术成功,无中转开腹,平均消融时间(26.4±2.7)min,术中平均出血量(27.6±5.2)mL,术后平均住院日(3.7±1.4)d。并发症包括:血红蛋白尿20例(23.3%),皮肤灼伤3例(3.5%),发热11例(12.8%),气胸1例(1.2%),无术后出血、胆汁漏、邻近脏器损伤等严重并发症。术后随访6~12个月,平均7.8个月。病灶残留小于10%者82例(95.3%),病灶残留10%~15%者3例(3.5%),病灶残留大于15%者1例(1.2%)。结论:采用腹腔镜微波消融治疗巨大肝血管瘤安全有效,推荐临床应用。

Objective： To investigate the efficacy and technical aspects of laparoscopic microwave ablation in treatment of giant hepatic hemangioma. Methods： The clinical data of 86 patients with hepatic hemangioma larger than 5 cm in diameter undergoing laparoscopic microwave ablation from January 2015 to D ecember 2015 were retrospectively analyzed. Results： Laparoscopic microwave ablations were performed successfully in all the 86 patients without any open conversion. The average ablation time was （26.4＋2.7） min, average blood loss was （27.6＋5.2） mL and average length of postoperative hospital stay was （3.7-＋1.4） d. The complications included hemoglobinuria in 20 cases （23.3%）, skin burns in 3 cases （3.5%）, fever in 11 cases （12.8%）, and pneumothorax in one case （1.2%）, but no serious complications such as postoperative hemorrhage, bile leakage and adjacent organ injuries occurred. Postoperative follow-up was conducted for 6 to 12 months. ＂/here were 82 cases （95.3%） with residualhemangioma lesion of less than 10%, 3 cases （3.5%） with residual lesion ranging from 10% to 15%, and one case （1.2%） with residual lesion more than 15%. Conclusion： Laparoscopic microwave ablation is safe and effective in treatment of giant hepatic hemangiomaj and it is recommended to be used in clinical practice.