腹腔镜超声辅助微波消融治疗肝血管瘤的临床应用

Clinical Application of Laparoscopic Ultrasound-assisted Microwave Ablation in the Treatment of Hepatic HeiTiailgiorna

【目的】探讨应用腹腔镜超声辅助微波消融治疗肝血管瘤的可行性及技术要点。【方法】回顾性分析2018年3月至2019年10月采用腹腔镜超声辅助微波消融治疗9例直径>5cm的肝血管瘤患者的临床资料。【结果】9例均消融治疗成功,无中转开腹,平均手术时间(189±58)min,平均消融时间(21土4.8)min,术中平均出血量(138士245)mL,术后平均住院日(7.8士1.4)d;并发症主要有:血红蛋白尿4例(44.44%),发热4例(44.44%),肝内胆汁瘤1例(11.11%),无气胸、术后出血、皮肤灼伤、邻近脏器损伤等严重并发症。术后随访6〜12个月,平均8.2个月。病灶完全消失者8例(88.89%),病灶缩小大于75%者1例(11.11%)。【结论】采用腹腔镜超声辅助微波消融治疗肝血管瘤临床疗效满意,值得临床推广应用。

【Objective】To investigate the efficacy and technical aspects of laparoscopic ultrasound-assisted microwave ablation in the treatment of hepatic hemangioma.【Methods】The clinical data of 9 patients with hepatic hemangioma larger than 5 cm in diameter undergoing laparoscopic ultrasound-assisted microwave ablation from March 2018 to October 2019 were retrospectively analyzed.【Results】Laparoscopic ultrasound-assisted microwave ablations were performed successfully in all the 9 patients without any open conversion.The average operation time was(189±58)min,average ablation time was(21±4.8)min,average blood loss was(138±245)mL,and the average length of postoperative hospital stay was(7.8±1.4)d.The main complications included hemoglobinuria in 4 cases(44.44%),fever in 4 cases(44.44%),and intrahepatic biloma in one case(11.11%),but no serious complications such as pneumothorax,postoperative hemorrhage,skin burned and adjacent organ injuries occurred.Postoperative follow-up was conducted for 6 to 12 months.There were 8 cases(88.89%)with complete elimination of lesions,and I case(11.11%)with lesion reduction more than 75%.【Conclusion】Laparoscopic ultrasound-assisted microwave ablation is safe and effective in treatment of hepatic hemangioma,and it is recommended to be used in clinical practice.