Jin Xin, Zhu Ziman, Zhao Wei, Sun Liyuan, Hu Bin, Huan Hongbo, Tu Yuliang, Wang Dadong, Jiang Kai
Faculty of Hepato-Biliary-Pancreatic Surgery, Institute of Hepatobiliary Surgery of Chinese PLA, Key Laboratory of Digital Hepatobiliary Surgery, Chinese People's Liberation Army (PLA) General Hospital, No. 28 Fuxing Road, Beijing, 100853, China.
World J Surg Oncol. 2025 May 24;23(1):203. doi: 10.1186/s12957-025-03856-5.
Hepatic hemangioma is the most common benign liver tumor. This study aims to evaluate the feasibility, safety and efficacy of Trans-arterial embolization (TAE) combined with thermal ablation in the treatment of large hepatic hemangioma (> 5 cm).
From January 2018 to December 2021, 82 patients and 112 large HH with a maximum mean diameter of 8.24 ± 0.26 cm (range: 4.3-16.0 cm) and a cumulative diameter of 9.45 ± 0.45 cm (range:5.0-29.6 cm) were treated with laparoscopic-assisted and ultrasound (US)-guided percutaneous radiofrequency ablation (RFA) or microwave ablation (MWA) during a single general anesthesia episode following TAE. After surgery, therapeutic efficacy was assessed by contrast-enhanced imagings during follow-up. Median follow-up time was 14 months (range: 2-48 months).
All patients have a mean operating time of 79.10 ± 2.59 min. The plain CT revealed that 112 treated lesions were totally covered (100%). Hemoglobinuria was detected in 28 patients (34.1%), and there were no cases of acute renal failure. Abdominal pain occurred in 40 patients (48.8%), while peritoneal effusion in six (7.3%). Acute cholecystitis developed in 11 patients (13.4%), constipation in five (6.1%), and nausea and vomiting in 14 (17.1%). According to the Clavien-Dindo classification, 54 patients (65.9%) had minor complications, while none had severe complications. The follow-up, no Hepatic hemangioma growth was observed.
Preoperative TAE combined with thermal ablation is a novel therapeutic strategy for large HH. This strategy is simple, less risky, and feasible.
肝血管瘤是最常见的肝脏良性肿瘤。本研究旨在评估经动脉栓塞（TAE）联合热消融治疗大型肝血管瘤（>5 cm）的可行性、安全性和疗效。
2018年1月至2021年12月，82例患者共112个大型肝血管瘤接受治疗，最大平均直径为8.24±0.26 cm（范围：4.3 - 16.0 cm），累积直径为9.45±0.45 cm（范围：5.0 - 29.6 cm）。在TAE后的单次全身麻醉期间，采用腹腔镜辅助和超声（US）引导下经皮射频消融（RFA）或微波消融（MWA）治疗。术后，通过随访期间的对比增强成像评估治疗效果。中位随访时间为14个月（范围：2 - 48个月）。
所有患者平均手术时间为79.10±2.59分钟。平扫CT显示112个治疗病灶全部被覆盖（100%）。28例患者（34.1%）检测到血红蛋白尿，无急性肾衰竭病例。40例患者（48.8%）出现腹痛，6例（7.3%）出现腹腔积液。11例患者（13.4%）发生急性胆囊炎，5例（6.1%）出现便秘，14例（17.1%）出现恶心呕吐。根据Clavien-Dindo分类，54例患者（65.9%）有轻微并发症，无严重并发症。随访期间，未观察到肝血管瘤生长。
术前TAE联合热消融是治疗大型肝血管瘤的一种新型治疗策略。该策略简单、风险小且可行。
