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Li J, Zhang S, Ning C, Li G, Guo S. Efficacy of radiofrequency ablation vs. transcatheter arterial embolization for hepatic hemangiomas. Eur J Gastroenterol Hepatol 2024; 36:750-757. [PMID: 38555605 PMCID: PMC11045395 DOI: 10.1097/meg.0000000000002724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 01/10/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVE The objective of this study was to evaluate the safety and effectiveness of radiofrequency ablation (RFA) and transcatheter arterial chemoembolization (TACE) in the treatment of large hepatic hemangiomas (LHH) (5-9.9 cm in diameter). METHODS AND MATERIALS This study retrospectively collected data from 82 patients with LHH treated at Chaoyang Central Hospital. The study analyzed the differences in postoperative efficacy, operative time, blood routine, liver and kidney function on the first day after surgery, postoperative hospitalization time and postoperative complications. RESULTS There were statistically significant differences in indicators such as white blood cell count, alanine aminotransferase, aspartate aminotransferase and total bilirubin on the first day after surgery between the RFA group (39 cases) and the TACE group (43 cases) ( P < 0.001). Compared to RFA, LHH patients treated with TACE had a general complication rate of 39.5% (vs. 43.6%; P = 0.7), a procedure-related complication rate of 30.2% (vs. 59.0%; P = 0.009), an effective rate at 6-12 months postoperatively of 55.8% (vs. 82.1%; P = 0.01), an operating-time of 41.2 ± 14.9 min (vs. 100.8 ± 35.5 min; P < 0.001) and hospitalization costs of 17052.7 ± 1364.8 yuan (vs. 30952.1 ± 4327.6 yuan; P < 0.001). CONCLUSION This study indicates that the efficacy of RFA in treating LHH is significantly superior to TACE. Microwave ablation and RFA appear to be safe treatments for LHH. The TACE group exhibited shorter operating-time, lower hospitalization costs and lower demands on cardiopulmonary function.
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Affiliation(s)
- Jushang Li
- Chaoyang Central Hospital, China Medical University
| | - Shuaiguo Zhang
- Department of General Surgery, Chaoyang Central Hospital, Chaoyang, Liaoning, China
| | - Chunmin Ning
- Department of General Surgery, Chaoyang Central Hospital, Chaoyang, Liaoning, China
| | - Guoming Li
- Department of General Surgery, Chaoyang Central Hospital, Chaoyang, Liaoning, China
| | - Shigang Guo
- Department of General Surgery, Chaoyang Central Hospital, Chaoyang, Liaoning, China
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Huang XY, Lu QS, Wu SP, Huang HM, Zhang YF. Changes in liver and kidney function, red blood cell count and hemoglobin levels 1 day after ultrasound-guided percutaneous microwave ablation for uterine fibroids. Int J Hyperthermia 2024; 41:2338542. [PMID: 38684224 DOI: 10.1080/02656736.2024.2338542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 03/31/2024] [Indexed: 05/02/2024] Open
Abstract
OBJECTIVE To investigate the changes in liver and kidney function, red blood cell (RBC) count and hemoglobin (HGB) levels in patients undergoing ultrasound-guided percutaneous microwave ablation (UPMWA) for uterine fibroids on postoperative day 1. METHODS The changes in liver and kidney function, RBC count and HGB levels in 181 patients who underwent selective UPMWA in the Second Affiliated Hospital of Shantou University Medical College, China, between August 2017 and January 2023 were retrospectively analyzed. RESULTS All patients underwent UPMWA for uterine fibroids; 179 patients had multiple uterine fibroids and 2 patients had single uterine fibroids. The maximum fibroid diameter ranged from 18 to 140 mm, with an average of 68.3 mm. Ultrasound imaging was used to confirm that the blood flow signal within the mass had disappeared in all patients, indicating that the ablation was effective. Within 24 h, compared with before UPMWA, levels of total bilirubin, direct bilirubin, indirect bilirubin and aspartate aminotransferase had significantly increased (p < 0.01), whereas levels of total protein, albumin, globulin, alanine aminotransferase, creatinine and urea had significantly decreased (p < 0.01). Acute kidney injury (AKI) occurred in 1 of the 181 patients. The RBC count and HGB levels decreased significantly after UPMWA (p < 0.01). CONCLUSION Ultrasound-guided percutaneous microwave ablation for uterine fibroids can impose a higher detoxification load on the liver and cause thermal damage to and the destruction of RBCs within local circulation, potentially leading to AKI. Protein levels significantly decreased after UPMWA. Therefore, perioperative organ function protection measures and treatment should be actively integrated into clinical practice to improve prognosis and enhance recovery.
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Affiliation(s)
- Xiao-Yu Huang
- Department of Anesthesiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Qin-Sheng Lu
- Department of Anesthesiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Shao-Ping Wu
- Department of Anesthesiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Han-Ming Huang
- Department of Anesthesiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
| | - Yong-Fa Zhang
- Department of Anesthesiology, Second Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong Province, China
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Xu L, Wu S, Kong J, Ke S, Yin T, Guo S, Ning C, Wang X, Li S, Ding J, Li A, Kong X, Wang Q, Xu Y, Gao J, Sun W. Thermal ablation of hepatic hemangioma: A multi-center experience with long-term outcomes. Eur J Radiol 2023; 164:110842. [PMID: 37172442 DOI: 10.1016/j.ejrad.2023.110842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 03/31/2023] [Accepted: 04/14/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Thermal ablation, currently used extensively for liver tumors, also has been applied. successfully to hepatic hemangioma; however, it is still considered experimental because previous studies have comprised small sample sizes with short follow-up periods. PURPOSE We aimed to investigate the effectiveness, safety, and long-term outcomes of thermal ablation for hepatic hemangioma. MATERIALS AND METHODS From October 2011 to February 2021, the data of 357 patients with 378 hepatic hemangiomas treated by thermal ablation at six hospitals were analyzed in this retrospective study. The technical success, safety, and long-term follow-up results were analyzed. RESULTS A total of 252 patients (mean age, 49.2 ± 10.5 years) with 273 subcapsular hemangiomas underwent laparoscopic thermal ablation, whereas 105 patients with 105 hemangiomas located in the liver parenchyma underwent CT-guided percutaneous ablation. Of the 378 hepatic hemangiomas (5.0-21.2 cm), 369 lesions were subjected to one session of ablation, while 9 lesions were subjected to two sessions of ablation. Technical success was achieved in 100.0% of cases. Complete ablation was achieved in 361 of 378 hemangiomas (95.5%), while 17 hemangiomas (4.5%) were incompletely ablated, showing subtle enhancement at the peripheral rim. The major complication rate was 2.0% (7/357). The median follow-up period was 67 months (range, 12-124 months). Of the 224 patients with hemangioma-related symptoms, 216 demonstrated complete disappearance of symptoms (96.4%), while 8 were ameliorated (3.6%). Ablated lesion shrinkage was progressive, and 11.4% of hemangiomas almost completely disappeared over time (P < 0.01). CONCLUSION With a reasonable ablation strategy and comprehensive treatment measurements, thermal ablation could be a safe, feasible, and effective treatment option for hepatic hemangioma.
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Affiliation(s)
- Li Xu
- Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100043, China
| | - Shilun Wu
- Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100043, China
| | - Jian Kong
- Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100043, China
| | - Shan Ke
- Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100043, China
| | - Tao Yin
- Department of General Surgery, Affiliated Hospital of Chifeng University, Chifeng 024000, Inner Mongolia Autonomous Region, China
| | - Shigang Guo
- Department of General Surgery, Chaoyang Central Hospital, Chaoyang 122000, Liaoning Province, China
| | - Chunmin Ning
- Department of General Surgery, Chaoyang Central Hospital, Chaoyang 122000, Liaoning Province, China
| | - Xiangtao Wang
- Department of General Surgery, Binzhou Second People's Hospital, Binzhou 256000, Shandong Province, China
| | - Shangshen Li
- Department of General Surgery, Binzhou Second People's Hospital, Binzhou 256000, Shandong Province, China
| | - Jianhua Ding
- Department of General Surgery, Binzhou Second People's Hospital, Binzhou 256000, Shandong Province, China
| | - Aolei Li
- Department of General Surgery, Chaoyang Second Hospital, Chaoyang 122000, Liaoning Province, China
| | - Xinliang Kong
- Department of Hepatobiliary Surgery, Rizhao Central Hospital, Rizhao 276801, Shandong Province, China
| | - Qiang Wang
- Department of Hepatobiliary Surgery, Rizhao Central Hospital, Rizhao 276801, Shandong Province, China
| | - Yanjie Xu
- Department of Hepatobiliary Surgery, Rizhao Central Hospital, Rizhao 276801, Shandong Province, China
| | - Jun Gao
- Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100043, China.
| | - Wenbing Sun
- Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing 100043, China.
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Maruyama H, Tobari M, Nagamatsu H, Yamaguchi T, Shiina S. Ablation for Benign Liver Tumors: Current Concepts and Limitations. J Clin Transl Hepatol 2023; 11:244-252. [PMID: 36406314 PMCID: PMC9647100 DOI: 10.14218/jcth.2022.00205] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 07/21/2022] [Accepted: 07/26/2022] [Indexed: 12/04/2022] Open
Abstract
Percutaneous ablation under imaging guidance is a curative treatment that can induce complete tumor necrosis with advantages of minimal invasiveness and a low risk of complications. Thermal ablation, which includes radiofrequency ablation and microwave ablation, is a representative technique that has sufficient antitumor effects in cases of hepatocellular carcinoma with ≤3 lesions measuring ≤3 cm and preserved liver function. The short- and long-term outcomes of patients are comparable with those achieved with surgical resection. Despite their nonmalignant nature, some benign liver tumors require treatment for symptoms caused by the presence of the tumor and/or continuous enlargement. Ablation may be the treatment of choice because it has lower burden on patients than surgical treatment. This review describes the recent concepts, progress, and limitations of ablation-based treatment for benign liver tumors.
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Affiliation(s)
- Hitoshi Maruyama
- Department of Gastroenterology, Juntendo University, Tokyo, Japan
- Correspondence to: Hitoshi Maruyama, Department of Gastroenterology, Juntendo University, 2-1-1, Hongo, Bunkyo-ku, Tokyo 113-8421, Japan. ORCID: https://orcid.org/0000-0003-3371-3157. Tel: +81-3-38133111, Fax: +81-3-56845960, E-mail:
| | - Maki Tobari
- Department of Gastroenterology, Juntendo University, Tokyo, Japan
| | | | - Tadashi Yamaguchi
- Center for Frontier Medical Engineering, Chiba University, Chiba, Japan
| | - Shuichiro Shiina
- Department of Gastroenterology, Juntendo University, Tokyo, Japan
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Barrow B, Martin Ii RCG. Microwave ablation for hepatic malignancies: a systematic review of the technology and differences in devices. Surg Endosc 2023; 37:817-834. [PMID: 36076101 DOI: 10.1007/s00464-022-09567-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 08/15/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Microwave ablation (MWA) has become the standard thermal-based treatment for hepatic malignancies in patients who have unresectable disease based on the biology of the tumor, the patients' comorbidities, and certain disease sites. The technical effectiveness, ablation success, local recurrence rates of hepatic malignancies treated with the various commercial microwave ablation devices has not been previously published in the peer reviewed literature. The aim of this systematic review is to summarize the clinical outcomes for the various MWA devices in the use of a hepatic malignancies to best educate hepatic surgeons as well as interventional radiologists. METHODS A comprehensive review of the literature and instructions for use of each device that was published from 1/2013 to 12/2020 was performed. The main outcomes extracted were technical success, ablation success, major complications, local and new recurrence rates, recurrence-free survival, ablation volumes, time, and the number of antennas required. A qualitative review of the literature was performed. RESULTS In total, 29 studies reporting data on 3250 patients and 4500 tumors were included in this review. Median patient age was 60.5 years (range 3-91). 76.3% (2420 M/753 F) of patients were male. Hepatocellular carcinoma (55%) was the most common tumor pathology followed by colorectal liver metastasis (10%) and cholangiocarcinoma (4%). A majority of studies reported technical success (range, 91.6-100%) and ablation success (range, 73.1-100%), as well as major complications (range, 0-9.1%). Local recurrence (range, 0-50%) was reported by 21 of the studies; however, new recurrence (range, 12.2-64%) was reported less frequently (6 studies) and were further specified in 12, six, and four studies as intrahepatic distant recurrence (11.3-54.2%), extrahepatic distant recurrence (3.6-20%), and metastasis (1.1-36%). A total of three, six, and five studies report disease, progression, and recurrence-free survival rates, respectively. CONCLUSION Microwave ablation is frequently used for the treatment of hepatic malignancies. A thorough understanding of the clinical outcomes associated with different pathologies and MWA devices can improve surgeon awareness and help prepare for operative planning and patient management. More consistent reporting of key outcomes in the literature is needed to achieve such an understanding.
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Affiliation(s)
- Brooke Barrow
- Department of Surgery, Division of Surgical Oncology, University of Louisville School of Medicine, 315 E. Broadway, Louisville, KY, 40292, USA
| | - Robert C G Martin Ii
- Department of Surgery, Division of Surgical Oncology, University of Louisville School of Medicine, 315 E. Broadway, Louisville, KY, 40292, USA.
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Fei L, Hongsong X. Effectiveness of microwave ablation for the treatment of hepatic hemangioma - meta-analysis and meta-regression. Int J Hyperthermia 2022; 40:2146214. [PMID: 36535918 DOI: 10.1080/02656736.2022.2146214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The treatment of hepatic hemangioma includes surgical resection, radiofrequency ablation and Transarterial embolization. However, complications, mortality and compromised effectiveness limit their applications. Microwaves with effective heating generation and short ablation time become a promising treatment. The aim of this study is to conduct systematic review and meta-analyses to evaluate the effectiveness of Microwave Ablation (MWA) for the treatment of hepatic hemangioma. METHODS A systematic literature review was conducted in PubMed. Main outcomes were defined as hemangioma decreases in diameters and volume changes post-MWA. Conventional random-effect meta-analysis technique was applied to analyze the pooled data, and meta-regression model was established to explore the association among factors. RESULTS There were nine studies with a total of 501 patients retrieved. The pooled estimate of mean differences and 95% CI of hemangioma decreases after MWA treatment in diameter and in volume change (%) were 3.009 cm and (1.856, 4.161), and 53.169% and (51.274, 55.065), respectively. The pooled estimates of liver enzyme, ALT and AST, elevation were 219.905 with 95%CI (160.860, 278.949) and 315.679 with 95%CI (226.961, 404.397), respectively. Major complications were defined as acute kidney injury (AKI), pleural effusion, diaphragmatic hernia, and jaundice that needed to be treated, and the pooled incidence was 0.017 with 95% CI of (0.006, 0.029). No mortality related to MWA was reported. Meta-regression showed ablation time was associated with pre-operative lesion size (p = .001). CONCLUSION MWA is effective and safe in treatment of hepatic hemangioma, and our study suggests that hemangioma size should be investigated in the future MWA pretreatment difficulty scoring system study.
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Affiliation(s)
- Li Fei
- Department of Hepatobiliary and Pancreatic Surgery, Ward 2, PUREN Hospital Affiliated to WUHAN University of Science and Technology, Wuhan, China
| | - Xing Hongsong
- Department of Hepatobiliary and Pancreatic Surgery, Ward 2, PUREN Hospital Affiliated to WUHAN University of Science and Technology, Wuhan, China
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Lin Z, Zhu X, Zhou J. Ultrasound-guided percutaneous sclerotherapy versus surgical resection in the treatment of large hepatic hemangiomas: a retrospective study. BMC Surg 2022; 22:130. [PMID: 35392876 PMCID: PMC8991895 DOI: 10.1186/s12893-022-01574-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 03/28/2022] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND It is no consensus on the best management for patients with large hepatic hemangiomas. This study was designed to evaluate the efficacy and safety of percutaneous sclerotherapy compared to surgical resection for large hepatic hemangiomas. METHODS A total of 89 patients with large hepatic hemangiomas from single center underwent either percutaneous sclerotherapy (n = 14) or surgical resection (n = 75) as first-line treatment was retrospectively studied, followed up for 9-24 months using ultrasound. Terms of intraoperative and postoperative information, postoperative complications, and treatment effectiveness were compared between the two groups. RESULTS Percutaneous sclerotherapy had shorter operative time (p < 0.001), less blood loss, lower rate of prophylactic abdominal drainage (97.3% vs. 0%, p < 0.001), fewer minor complications (48.0% vs. 7.1%, p < 0.01), shorter hospital stay (p < 0.001), lower hospital cost (p < 0.001), higher Alb level (p < 0.001) and lower postoperative clinical index including ALT, AST and WBC (p < 0.001 for both) than did surgical resection. The major complications were demonstrated no significant difference between the two groups. In addition, the mean maximum cross-sectional areas of hemangioma dropped from 5044.1 ± 2058.0 mm2 to 1924.6 ± 1989.5 mm2 (65.2% reduction) during 9-24 months follow-up (p < 0.001) in the percutaneous sclerotherapy group, while all patients in the surgical resection group achieved complete response. CONCLUSION Percutaneous sclerotherapy is the preferred method for the treatment of large hepatic hemangioma over surgical resection when compared with the items of postoperative recovery, blood loss, complications, hospital stays, and lower hospital costs. The reduction of the maximum cross-sectional area of hepatic hemangioma in the percutaneous sclerotherapy group is satisfactory.
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Affiliation(s)
- Zepeng Lin
- Organ Transplant Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xiaofeng Zhu
- Organ Transplant Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
| | - Jian Zhou
- Organ Transplant Center, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
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Safety and efficacy of microwave versus radiofrequency ablation for large hepatic hemangioma: a multicenter retrospective study with propensity score matching. Eur Radiol 2022; 32:3309-3318. [DOI: 10.1007/s00330-021-08425-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 10/15/2021] [Accepted: 10/18/2021] [Indexed: 12/17/2022]
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Wang S, Gao R, Zhao S, Zhu H, Zhang W, Kong X, Li P, Ma D, Gao J, Sun W. Safety and effectiveness of laparoscopic intratumoral resection facilitated by coagulation of giant hepatic hemangioma: a matched case-control study and literature review. Surg Endosc 2021; 36:5149-5159. [PMID: 34845546 DOI: 10.1007/s00464-021-08891-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 11/16/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND To report the safety and effectiveness of laparoscopic intratumoral resection facilitated by coagulation (LIRC) compared with laparoscopic hepatectomy (LH) in treating giant hepatic hemangioma. METHODS From 2017 to 2020, 19 consecutive patients with giant hepatic hemangioma (≥ 10 cm) received LIRC in one center. We selected a subgroup of 103 patients treated by LH in other four centers who well matched the 19 consecutive patients treated with LIRC, in a 1:1 fashion based on the tumor location, tumor size, and body mass index. Furthermore, the differences in technical success, operative time, operative blood loss, change of laboratory indexes, hospital stays, complication and clinical responds are compared between the two groups. RESULTS Technical success was achieved in all 38 patients. Patients in the LIRC group had a relative shorter operative time (P < 0.001) and less operative blood loss (P = 0.003). The serum levels of C-reactive protein (CRP), total bilirubin (TBil), alanine aminotransferase (ALT), and aspartate transaminase (AST) were elevated significantly (P < 0.05) 1 day after the resection and returned to normal within 7 days in both groups; however, relatively lower serum levels of those indexes were observed in the LIRC group (P < 0.05). The total complication rate was relatively lower in the LIRC group compared with the LH group (P = 0.029). Patients in the LIRC group had shorter hospital stays than those in the LH group (P = 0.010). The clinical response was similar in the two groups. CONCLUSIONS LIRC is safe and effective for treating giant hepatic hemangioma.
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Affiliation(s)
- Shaohong Wang
- Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, 100043, China
| | - Ruize Gao
- Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, 100043, China
| | - Shuchao Zhao
- Department of Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong Province, China
| | - Huaqiang Zhu
- Department of Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong Province, China
| | - Wenxuan Zhang
- Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, 100043, China
| | - Xinliang Kong
- Department of Hepatobiliary Surgery, Rizhao Central Hospital, Rizhao, 276801, Shandong Province, China
| | - Peng Li
- Department of General Surgery, Binzhou Second People's Hospital, Binzhou, 256800, Shandong Province, China
| | - Demin Ma
- Department of Hepatobiliary Surgery, Dezhou People's Hospital, Dezhou, 253000, Shandong Province, China
| | - Jun Gao
- Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, 100043, China.
| | - Wenbing Sun
- Department of Hepatobiliary Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, 100043, China.
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Wang LZ, Wang KP, Mo JG, Wang GY, Jin C, Jiang H, Feng YF. Minimally invasive treatment of hepatic hemangioma by transcatheter arterial embolization combined with microwave ablation: A case report. World J Clin Cases 2021; 9:7154-7162. [PMID: 34540972 PMCID: PMC8409202 DOI: 10.12998/wjcc.v9.i24.7154] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 07/07/2021] [Accepted: 07/14/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Hepatic hemangioma is the most common benign tumor of the liver. However, patients with large hemangiomas that cause compression symptoms or that are at risk of rupture may need further intervention. It is necessary to explore additional minimally invasive and personalized treatment options for hemangiomas.
CASE SUMMARY A 47-year-old woman was diagnosed with a right hepatic hemangioma for more than 10 years. Abdominal contrast-enhanced computed tomography (CT) and contrast-enhanced ultrasound revealed that there was a large hemangioma in the right liver, with a size of approximately 95 mm × 97 mm × 117 mm. Due to the patient's refusal of surgical treatment, hepatic artery embolization was performed in the first stage. After 25 d of liver protection treatment, the liver function indexes decreased to normal levels. Then, ultrasound-guided microwave ablation of the giant hepatic hemangioma was performed. Ten days after the treatment, hepatobiliary ultrasonography showed that the hemangioma of the right liver was smaller than the previous size (the volume was reduced by approximately 30%). Then the patient was discharged from the hospital. One year after discharge, CT showed that the hepatic hemangioma had shrunk by about 80%
CONCLUSION Transcatheter arterial embolization combined with microwave ablation is a safe and effective minimally invasive treatment for hepatic hemangioma.
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Affiliation(s)
- Lie-Zhi Wang
- Department of General Surgery, Taizhou Central Hospital (Taizhou University Hospital), Taizhou 318000, Zhejiang Province, China
| | - Kun-Peng Wang
- Department of General Surgery, Taizhou Central Hospital (Taizhou University Hospital), Taizhou 318000, Zhejiang Province, China
| | - Jing-Gang Mo
- Department of General Surgery, Taizhou Central Hospital (Taizhou University Hospital), Taizhou 318000, Zhejiang Province, China
| | - Guo-Yu Wang
- Department of Radiology, Taizhou Central Hospital (Taizhou University Hospital), Taizhou 318000, Zhejiang Province, China
| | - Chong Jin
- Department of General Surgery, Taizhou Central Hospital (Taizhou University Hospital), Taizhou 318000, Zhejiang Province, China
| | - Hao Jiang
- Department of General Surgery, Taizhou Central Hospital (Taizhou University Hospital), Taizhou 318000, Zhejiang Province, China
| | - Yi-Fu Feng
- Department of Hepatobiliary Surgery, Taizhou Central Hospital (Affiliated Hospital of Taizhou University), Taizhou 510000, Zhejiang Province, China
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Local Ablation Versus Surgical Resection for Liver Hemangioma: a Systematic Review and Meta-analysis. Indian J Surg 2021. [DOI: 10.1007/s12262-020-02234-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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Zhang Z, Li JZ, Li HM. Hepatic Hemangioma Treatment Using Microwave Coagulation Therapy—a Systematic Review. Indian J Surg 2021. [DOI: 10.1007/s12262-020-02372-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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13
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Zhuo S, Zhou J, Ruan G, Zeng S, Ma H, Xie C, An C. Percutaneous microwave ablation versus surgical resection for ovarian cancer liver metastasis. Int J Hyperthermia 2020; 37:28-36. [PMID: 31918591 DOI: 10.1080/02656736.2019.1706767] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Objective: To compare the oncological outcomes between microwave ablation (MWA) and surgical resection (SR) in patients with ovarian cancer liver metastasis (OCLM).Materials and methods: In this retrospective study, a total of 29 female patients (mean age, 47.8 ± 12.9 years; range, 21-65 years) diagnosed with forty-three OCLM nodules between September 2008 and July 2016 were included. All patients with ovarian cancer received chemotherapy and cytoreductive surgery (CRS). Fifteen patients with 22 nodules underwent MWA, and 14 patients with 21 nodules underwent SR. Overall survival (OS), local tumor recurrence-free survival (LTRS), and operation-related parameters were compared between the two groups. Multivariate analyses were performed on clinicopathological variables to identify factors affecting OS and LTRS.Results: The median follow-up time was 70.2 months (range, 12.1-107.2 months). Fourteen patients died during this period. The 1-, 3-, and 5-year OS and LTRS rates after MWA were comparable to those after SR (p = .198 and p = .889, respectively). Compared with the SR group, the MWA group had a shorter surgical time (p < .001), less estimated blood loss (p < .001), shorter postoperative hospitalization (p < .001) and fewer costs (p = .015). The multivariate analysis showed that old age (p = .001) was a predictor of poor OS and that intrahepatic tumor size (p = .005) and intrahepatic tumor number (p = .001) were predictors of poor LTRS.Conclusion: Percutaneous MWA had comparable oncologic outcomes with those of SR and could be a safe and effective treatment for OCLM.
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Affiliation(s)
- Shuiqing Zhuo
- Department of Radiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China
| | - Jian Zhou
- Department of Radiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China
| | - Guangying Ruan
- Department of Radiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China
| | - Sihui Zeng
- Department of Radiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China
| | - Huali Ma
- Department of Radiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China
| | - Chuanmiao Xie
- Department of Radiology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China
| | - Chao An
- Department of Minimal Invasive Intervention, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China
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14
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Shi Y, Song J, Ding M, Tang X, Wang Z, Chi J, Wang T, Ji J, Zhai B. Microwave ablation versus transcatheter arterial embolization for large hepatic hemangiomas: clinical outcomes. Int J Hyperthermia 2020; 37:938-943. [PMID: 32762267 DOI: 10.1080/02656736.2020.1766122] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
PURPOSE To evaluate the safety and effect of microwave ablation (MWA) compared with transcatheter arterial embolization (TAE) for the treatment of large hepatic hemangiomas. MATERIALS AND METHODS A total of 135 patients with symptomatic or/and enlarging hepatic hemangiomas (5-10 cm) from two centers underwent either MWA (n = 82) or TAE (n = 53) as first-line treatment. We compared the two groups in terms of radiologic response, clinical response, operative time, postoperative analgesic requirements, hospital stay and complications. RESULTS MWA had a significantly higher rate of complete radiologic response (89.0% vs. 37.7%, p<.001) and complete clinical response (88.6% vs. 69.2%, p=.046), fewer minor complications (43.9% vs. 66.0%, p=.019), shorter time of using analgesics (p<.001) and shorter hospital stays (p=.003) than did TAE. The operative time and major complications were comparable between the two groups. CONCLUSION Both MWA and TAE are safe and effective in treating patients with large hepatic hemangiomas. MWA had a higher rate of complete response than did TAE, and it was associated with fewer minor complications, faster recovery and shorter hospital stay.
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Affiliation(s)
- Yaoping Shi
- Department of Interventional Oncology, School of Medicine, Renji Hospital, Shanghai Jiao-tong University, Shanghai, China
| | - Jingjing Song
- Department of Radiology, Lishui Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical College, Lishui, China
| | - Min Ding
- Department of Interventional Oncology, School of Medicine, Renji Hospital, Shanghai Jiao-tong University, Shanghai, China
| | - Xiaoyin Tang
- Department of Interventional Oncology, School of Medicine, Renji Hospital, Shanghai Jiao-tong University, Shanghai, China
| | - Zhi Wang
- Department of Interventional Oncology, School of Medicine, Renji Hospital, Shanghai Jiao-tong University, Shanghai, China
| | - Jiachang Chi
- Department of Interventional Oncology, School of Medicine, Renji Hospital, Shanghai Jiao-tong University, Shanghai, China
| | - Tao Wang
- Department of Interventional Oncology, School of Medicine, Renji Hospital, Shanghai Jiao-tong University, Shanghai, China
| | - Jiansong Ji
- Department of Radiology, Lishui Central Hospital, The Fifth Affiliated Hospital of Wenzhou Medical College, Lishui, China
| | - Bo Zhai
- Department of Interventional Oncology, School of Medicine, Renji Hospital, Shanghai Jiao-tong University, Shanghai, China
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15
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Carnevale A, Pellegrino F, Cossu A, Ierardi AM, Parenti GC, Carrafiello G, Giganti M. Current concepts in ablative procedures for primary benign liver lesions: a step forward to minimize the invasiveness of treatment when deemed necessary. Med Oncol 2020; 37:31. [PMID: 32193648 PMCID: PMC7102179 DOI: 10.1007/s12032-020-01355-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 02/28/2020] [Indexed: 12/31/2022]
Abstract
With increased use of medical imaging, the incidental detection of benign solid liver tumors has become more frequent. Facing with benign disease, the indications for surgery are still object of discussion in light of the stable natural course of most lesions and obvious drawbacks of any surgical intervention; therefore, in most situations, a conservative approach is recommended, and surgery is mainly reserved for those cases with persistent or worsening symptoms, or who are at risk for complications as malignant transformation. The advent of ablative techniques has widened the range of treatment options available to these patients, presenting as a valid alternative to resection in terms of safety and efficacy in selected cases, particularly in patients who are considered poor surgical candidates and with smaller lesions. This review outlines the role of percutaneous ablative methods for benign solid liver tumors that are encountered in adults, providing a per histology analysis of the existing evidence. The up-to-date strategies for management of the most common benign solid tumors are recapitulated.
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Affiliation(s)
- Aldo Carnevale
- University Radiology Unit, Radiology Department, Arcispedale Sant'Anna, Via A. Moro 8, Ferrara, 44123, Italy
| | - Fabio Pellegrino
- Department of Morphology, Surgery and Experimental Medicine, Radiology Section, University of Ferrara, Via L. Ariosto 35, Ferrara, 44121, Italy
| | - Alberto Cossu
- University Radiology Unit, Radiology Department, Arcispedale Sant'Anna, Via A. Moro 8, Ferrara, 44123, Italy
| | - Anna Maria Ierardi
- Diagnostic and Interventional Radiology Department, ASST Santi Paolo E Carlo, San Paolo Hospital, University of Milan, Via A di Rudinì 8, Milan, 20142, Italy
| | - Gian Carlo Parenti
- Department of Diagnostic Imaging of Romagna, Ospedale Civile Santa Maria Delle Croci, Ravenna, 48100, Italy
| | - Gianpaolo Carrafiello
- Diagnostic and Interventional Radiology Department, ASST Santi Paolo E Carlo, San Paolo Hospital, University of Milan, Via A di Rudinì 8, Milan, 20142, Italy
| | - Melchiore Giganti
- Department of Morphology, Surgery and Experimental Medicine, Radiology Section, University of Ferrara, Via L. Ariosto 35, Ferrara, 44121, Italy.
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