کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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4307691 | 1289254 | 2013 | 8 صفحه PDF | دانلود رایگان |
![عکس صفحه اول مقاله: Radiofrequency ablation for large hepatic hemangiomas: Initial experience and lessons Radiofrequency ablation for large hepatic hemangiomas: Initial experience and lessons](/preview/png/4307691.png)
ObjectiveWe aimed to assess the feasibility, safety, and efficacy of radiofrequency (RF) ablation for the treatment of large (≥5 cm in greatest diameter) hepatic hemangiomas.MethodsThirty-six patients (15 male, 21 female; mean age 50 years) with 41 hepatic hemangiomas ≥5 cm in diameter were enrolled and treated with RF ablation attributable to the presence of enlargement tendency and/or persistent hemangioma-associated symptoms. Twenty patients had 24 hemangiomas <10 cm, and 16 patients had 17 hemangiomas ≥10 cm. Technical success, complications related to RF ablation, completed ablation, symptom relief, change in size of ablation zone, and recurrence of the residual tumor were analyzed.ResultsOf the 41 hemangiomas with a mean diameter 10 ± 4 cm (range, 5–22 cm), 26 subcapsular lesions were treated with a laparoscopic approach, and 15 lesions located in liver parenchyma underwent a computed tomography–guided percutaneous approach. RF ablation was performed successfully in all patients. There were 62 complications related to the ablation in 22 patients, including 6 of 20 patients with hemangiomas <10 cm and all the 16 patients with hemangiomas ≥10 cm. According to the Dindo–Clavien classification, 2 complications (lower esophageal fistula and acute respiratory distress syndrome, Grade III and Grade IV, respectively) were major in 2 patients with hemangiomas ≥10 cm; all the other were minor in 20 patients (Grade I). All the complications were recovered by conservative treatment. Thirty-eight (93%) of 41 hepatic hemangiomas were ablated completely, including all the 24 lesions <10 cm and 14 of 17 lesions ≥10 cm. All the symptoms related to hemangiomas disappeared (n = 22) or were ameliorated (n = 4) after ablation. The mean diameter of ablation zone was decreased to 6 ± 3 cm (2–12 cm) in a mean follow-up period (X ± SD) of 15 ± 6 months (range, 6–24 months), without recurrence or enlargement of the 3 residual tumors.ConclusionThe present study supports RF ablation as an alternative treatment for hepatic hemangiomas ≥5 cm (but smaller than 10 cm) for the low risk of complications and likelihood of complete ablation, but, in contrast, RF ablation appears to be an inappropriate method for hepatic hemangiomas ≥10 cm because of the high occurrence rate of complications.
Journal: Surgery - Volume 153, Issue 1, January 2013, Pages 78–85