Institute of Hepatobiliary Surgery, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, PR China.
Department of Hepatobiliary Surgery, Shenzhen University General Hospital, Guangdong Provincial Key Laboratory of Regional Immunity and Diseases, Carson International Cancer Shenzhen University General Hospital, Shenzhen University Clinical Medical Academy Center, Shenzhen University, Shenzhen, China.
Int J Hyperthermia. 2020;37(1):212-219. doi: 10.1080/02656736.2020.1732484.
To evaluate the safety and efficacy of percutaneous ultrasound-guided 'three-step' radiofrequency ablation (RFA) for the treatment of giant hepatic hemangioma. Patients with giant hepatic hemangioma who underwent percutaneous ultrasound-guided 'three-step' RFA ( = 52) and conventional RFA ( = 54) at our center from June 2013 to December 2017 were retrospectively analyzed. The 'three-step' RFA proceeds as follows. Step 1: Ablate the feeding artery of the hemangioma. Step 2: Aspirate blood from the tumor. Step 3: Ablation the lesion. Intraoperative information, postoperative recovery, therapeutic effects, and complications were compared between the two groups. The duration of RFA was significantly shorter (19.2 ± 0.8 min versus 44.5 ± 2.8 min, < 0.001), the number of punctures was significantly lower (3.2 ± 0.1 versus 4.7 ± 0.3, = 0.002), and the duration of hospital stay was significantly shorter (9.0 ± 0.5 versus 11.5 ± 0.7, = 0.013) in the TS-RFA group than in the C-RFA group. The complete ablation rate (86.5% versus 40.7%), the maximum postoperative pain score (2.5 ± 1.3 versus 4.1 ± 2.0) and symptom relief were also significantly better in the TS-RFA group than in the C-RFA group ( < 0.05). No postoperative death occurred in either group. There were no grade III or higher complications in the TS-RFA group, but one patient in the C-RFA group developed the grade III complication of postoperative abdominal bleeding. 'Three-step' RFA is a safe and effective minimally invasive treatment for giant hepatic hemangioma. It is worthy of further promotion and application.
评估经皮超声引导下“三步法”射频消融（RFA）治疗巨大肝血管瘤的安全性和有效性。
回顾性分析 2013 年 6 月至 2017 年 12 月在我院行经皮超声引导下“三步法”RFA（ = 52）和常规 RFA（ = 54）治疗的巨大肝血管瘤患者的临床资料。“三步法”RFA 步骤如下：①消融肿瘤供血动脉；②抽吸肿瘤内血液；③消融病灶。比较两组患者术中资料、术后恢复情况、疗效及并发症。
“三步法”RFA 组 RFA 时间明显短于常规 RFA 组（19.2 ± 0.8 分钟比 44.5 ± 2.8 分钟， < 0.001），穿刺次数明显少于常规 RFA 组（3.2 ± 0.1 次比 4.7 ± 0.3 次， = 0.002），住院时间明显短于常规 RFA 组（9.0 ± 0.5 天比 11.5 ± 0.7 天， = 0.013）。“三步法”RFA 组完全消融率（86.5%比 40.7%）、术后最大疼痛评分（2.5 ± 1.3 分比 4.1 ± 2.0 分）和症状缓解均明显优于常规 RFA 组（ < 0.05）。两组均无术后死亡病例。“三步法”RFA 组无Ⅲ级及以上并发症，常规 RFA 组有 1 例发生Ⅲ级术后腹腔出血并发症。
“三步法”RFA 是治疗巨大肝血管瘤的一种安全、有效的微创治疗方法，值得进一步推广应用。
