腹腔镜下微波消融治疗特殊肝段大血管瘤或肝巨大血管瘤临床效果观察

Clinical effect of laparoscopic microwave ablation for special hepatic segment large hemangioma or hepatic giant hemangioma

目的观察腹腔镜下微波消融治疗特殊肝段大血管瘤或肝巨大血管瘤的临床效果。方法回顾性分析解放军总医院第八医学中心自2016年6月至2019年1月收治的24例采用腹腔镜下微波消融治疗肝血管瘤的患者的临床资料。观察并记录患者的围术期指标及预后情况。结果 24例患者均顺利完成腹腔镜下微波消融治疗,共消融26个血管瘤,其中,8个采用单针消融,18个采用双针消融,单个血管瘤平均消融时间(32.0±10.3)min。术后并发症均为Dindo-Clavien分级Ⅰ级并发症,经药物治疗后恢复良好,无Ⅱ级及以上并发症。26个血管瘤中,22个完全消融,消融率为84.6%;其余4个消融灶残留,临床继续观察,如增大考虑二次消融。结论腹腔镜下微波消融治疗特殊肝段大血管瘤或肝巨大血管瘤安全有效。

Objective To observe the clinical effect of microwave ablation under laparoscope in the treatment of special large hepatic segment hemangioma or giant hepatic hemangioma.Methods A retrospective study was performed on 24 cases of patients with hepatic segment hemangioma who were admitted and underwent laparoscopic microwave ablation from June 2016 to January 2019.The perioperative indicators and prognosis of the patients were observed and recorded.Results All the 24 patients successfully completed laparoscopic microwave ablation,and a total of 26 hemangiomas were ablated.Among them,8 underwent single-needle ablation,18 underwent double-needle ablation,and the average ablation time of a single hemangioma was(32.0±10.3) minutes.Postoperative complications were Dindo-Clavien class Ⅰ complications,recovered well after drug treatment,no complications Ⅱ level and above.Of the 26 hemangiomas,22 were completely ablated with an ablative rate of 84.6%.The remaining 4 ablative lesions remained,and clinical observation was continued,such as the increase of secondary ablation.Conclusion Laparoscopic microwave ablation is safe,effective and minimal invasive in treatment for large hemangioma of special hepatic segment or huge hepatic hemangioma.