临床研究(Clinical Research)

腹腔镜下微波消融治疗巨大肝血管瘤:附86例报告

Published at: 2017年第26卷第7期

张磊 1 , 熊俊 2
1 华中科技大学同济医学院附属协和医院急诊外科,湖北 武汉 430022
2 华中科技大学同济医学院附属协和医院肝胆外科,湖北 武汉 430022
通讯作者 俊 熊 Email: oldxiong@188.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2017.07.014
基金:
国家自然科学基金资助项目 81371840
湖北省卫生和计划生育委员会科研基金资助项目 WJ2017Q021

摘要

目的:探讨应用腹腔镜微波消融治疗巨大肝血管瘤的疗效和技术要点。方法:回顾性分析2015年1月—2015年12月采用腹腔镜微波消融治疗86例直径>5 cm的肝血管瘤患者的临床资料。结果:86例均手术成功,无中转开腹,平均消融时间(26.4±2.7)min,术中平均出血量(27.6±5.2)mL,术后平均住院日(3.7±1.4)d。并发症包括:血红蛋白尿20例(23.3%),皮肤灼伤3例(3.5%),发热11例(12.8%),气胸1例(1.2%),无术后出血、胆汁漏、邻近脏器损伤等严重并发症。术后随访6~12个月,平均7.8个月。病灶残留小于10%者82例(95.3%),病灶残留10%~15%者3例(3.5%),病灶残留大于15%者1例(1.2%)。结论:采用腹腔镜微波消融治疗巨大肝血管瘤安全有效,推荐临床应用。


Laparoscopic microwave ablation for giant hepatic hemangioma: a report of 86 cases

Abstract

Objective: To investigate the efficacy and technical aspects of laparoscopic microwave ablation in treatment of giant hepatic hemangioma. Methods: The clinical data of 86 patients with hepatic hemangioma larger than 5 cm in diameter undergoing laparoscopic microwave ablation from January 2015 to December 2015 were retrospectively analyzed. Results: Laparoscopic microwave ablations were performed successfully in all the 86 patients without any open conversion. The average ablation time was (26.4±2.7) min, average blood loss was (27.6±5.2) mL and average length of postoperative hospital stay was (3.7±1.4) d. The complications included hemoglobinuria in 20 cases (23.3%), skin burns in 3 cases (3.5%), fever in 11 cases (12.8%), and pneumothorax in one case (1.2%), but no serious complications such as postoperative hemorrhage, bile leakage and adjacent organ injuries occurred. Postoperative follow-up was conducted for 6 to 12 months. There were 82 cases (95.3%) with residual hemangioma lesion of less than 10%, 3 cases (3.5%) with residual lesion ranging from 10% to 15%, and one case (1.2%) with residual lesion more than 15%. Conclusion: Laparoscopic microwave ablation is safe and effective in treatment of giant hepatic hemangioma, and it is recommended to be used in clinical practice.


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引用

引用本文: 磊 张, 俊 熊. 腹腔镜下微波消融治疗巨大肝血管瘤:附86例报告[J]. 中国普通外科杂志, 2017, 26(7): 902-906.
Cite this article as: ZHANG Lei, XIONG Jun . Laparoscopic microwave ablation for giant hepatic hemangioma: a report of 86 cases[J]. Chin J Gen Surg, 2017, 26(7): 902-906.