Microwave Ablation for Liver Hemangiomas
https://doi.org/10.16931/1995-5464.2015310-16
Abstract
Aim. To refine treatment of patients with liver hemangiomas with new minimally invasive method of surgical treatment (microwave ablation).
Material and Methods. The study included 64 patients with liver hemangiomas up to 5 cm in diameter. In 23 patients (35.9%) there was 2–2,5-fold increase of hemangioma's size within 1.5–4 years. The diagnosis of liver hemagioma was installed in all patients based on multispiral computed tomography (MSCT). Surgery was performed in X-ray operation theater under intravenous anesthesia. Inter- or infracostal approach was used depending on the location of hemangioma. Percutaneous transhepatic introduction of thermal probe was performed into hemangioma under ultrasound control
so that the tip of thermal probe has reached the opposite edge of the tumor. Then we applied microwave ablation for 15–20 minutes at temperature of 80–120 degrees. In the postoperative period within 2–3 days preventive antibiotic therapy as well as hepatoprotectors were administered. Effectiveness of method was evaluated at 3 (ultrasound) and 6 months (MSCT).
Results. 23 patients with liver hemangiomas were treated using percutaneous microwave ablation. Complications were not marked. In 21 (91.3%) patients one procedure was conducted, 2 patients (8.7%) required repeated ablation because of recurrence of tumor according to control MSCT. In patient with multiple hemangiomas simultaneous ablation of two the largest hemangiomas was performed. Patients were discharged at 3–5 days after surgery. The follow-up was 7–35 months (average period 24 months). Dynamic ultrasonic examination showed that within 2–3 months the patients
were able to form small liquid pockets in the site of ablation (7 patients), which independently regressed by the end of the 6th month followed by fibrosis. Presence of fibrous foci was confirmed by computed tomography at 6 months.
Conclusion. Percutaneous microwave ablation may be recommended for some patients with liver hemangiomas due to minimal invasiveness, efficiency, simplicity, safety and easy repeatability
About the Authors
A. F. Chernousov
Chair of Faculty Surgery №1
Russian Federation
Russian Federation
Doct. of Med. Sci., Professor, Academician of RASci, Head of Chair of Faculty Surgery cow State Medical University
G. Kh. Musaev
Chair of Faculty Surgery №1
Russian Federation
Russian Federation
Doct. of Med. Sci., Professor of the Chair of Faculty Surgery №1, I.M. Sechenov First Moscow State Medical University
G. A. Zhemerikin
Chair of Faculty Surgery №1
Russian Federation
Postgraduate Student at the Chair of Faculty Surgery №1, I.M. Sechenov First Moscow State Medical University
Russian Federation
Postgraduate Student at the Chair of Faculty Surgery №1, I.M. Sechenov First Moscow State Medical University
Yu. Yu. Yurichenko
Chair of Faculty Surgery №1
Russian Federation
Surgeon of University Clinical Hospital №1, I.M. Sechenov First Moscow State Medical University
Russian Federation
Surgeon of University Clinical Hospital №1, I.M. Sechenov First Moscow State Medical University
T. P. Nekrasova
Chair of Pathological Anatomy of Medical Faculty of I.M. Sechenov First Moscow State Medical University
Russian Federation
Russian Federation
Cand. of Med. Sci., Associate Professor at the Chair of Pathological Anatomy, I.M. Sechenov First Moscow
State Medical University
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Review
For citations:
Chernousov A.F., Musaev G.Kh., Zhemerikin G.A., Yurichenko Yu.Yu., Nekrasova T.P. Microwave Ablation for Liver Hemangiomas. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2015;20(3):10-16. (In Russ.) https://doi.org/10.16931/1995-5464.2015310-16
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