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Objective To analyze the complications caused by microwave ablation for hepatic cavernous hemangiomas, and to discuss the prevention and treatment of the complications. Methods During the period from July 2009 to May 2011 at authors’ hospital, a total of 34 times of microwave ablation procedure were carried out in 30 patients with hepatic cavernous hemangiomas. The microwave ablation-related complications were recorded and the prognosis was evaluated. Results Serious complications occurred in 2 patients (6.7%), including acute hemolysis leading to acute renal failure (n = 1) and abdominal wall abscess (n = 1). Postoperative fever was seen in 18 cases (60%), transient hemoglobinuria in 4 cases (13.3%), nausea with vomiting in 5 cases (16.7%), marked pain at the surgical area in 8 cases (26.7%), right pleural effusion in 4 cases (13.3%), hepatic dysfunction in 24 cases (80%) and leukocytosis in 11 cases (36.7%). No treatment-related death occurred. Conclusion For the treatment of hepatic cavernous hemangiomas, microwave ablation is minimally invasive with higher safety and satisfactory effect, although this technique carries somewhat higher risks when the hemangioma is larger or the location of the hemangioma is anatomically complicated. Some of these complications can be early detected and proper management should be actively adopted in order to avoid as well as to minimize the adverse results.
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Objective To analyze the factors that might affect the therapeutic results of pingyangmycin-lipiodol emulsion intra-arterial sclerosing embolization (PLE-IASE) in treating symptomatic cavernous hemangioma of liver (SCHL). Methods PLE-IASE was performed in 89 patients with SCHL (32 males and 57 females). Before treatment the mean diameter of the hemangioma was (8.3±3.8) cm. Of 89 patients, 53 experienced anxiety, 35 suffered from right upper abdominal pain and the remaining one developed Kasabach-Merrit syndrome. Before PLE-IASE, the arteriographic classification was conducted based on hepatic arteriographic findings. Then pingyangmycin-lipiodol emulsion (PLE) was injected through the feeding artery. The dosage of pingyangmycin (PYM) was (9.8±4.4) mg and the dosage of lipiodol (LP) was (5.9±2.9) ml. The lipiodol deposition status was judged by the follow-up spot film taken immediately after PLE-IASE. The observations of the occurrence of complications, the relief of symptoms and the minification of SCHL were followed for 6-72 months after PLE-IASE. The linear regression analysis statistics was conducted by taking the minification as dependent variable and taking the arteriographic classification, lipiodol deposition status, the dosage of PYM, the dosage of lipiodol and the preoperative SCHL diameter as independent variable. Results Of all 89 cases of SCHL, hypervascular type was seen in 51, hypovascular type in 26 and arteriovenous shunt (AVS) type in 12. Good lipiodol deposition status was found in 64 patients and poor deposition in 25 patients after PLE-IASE. After PLE-IASE, the symptom of anxiety in 53 patients was relieved and the right upper abdominal pain was reduced in 33 cases although intermittent pain still remained in 2 patients. The blood platelet count of the patient with Kasabach-Merrit syndrome returned to normal after the treatment. The symptomatic relieve rate was 98.7%. No serious complications occurred in the follow-up period. The linear regression analysis showed that arteriographic classification, lipiodol deposition status and PYM dosage used in treatment had statistically significant impact on tumor minification, while the preoperative diameter of SCHL and lipiodol dosage used in treatment had no statistically significant impact on it. Conclusion PLE-IASE is an effective and safe interventional treatment for SCHL. Arteriographic classification, lipiodol deposition status and PYM dosage used in treatment have a significant correlation with the minification of SCHL, while the preoperative diameter of SCHL and lipiodol dosage used in treatment bear no relationship to the minification of SCHL.
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Objective To evaluate the efficacy, safety and complications of minimally invasive percutaneous radiofrequency ablation(PRFA) therapy for hepatic cavernous hemangioma(HCH). Methods Twelve patients with total 15 HCHs (2.5cm to 9.5cm) were treated by using RF-2000 generator and 10-needle LeVeen electrode percutaneously guided by B-ultrasound. Tumors larger than 3cm were treated by multiple overlapping ablations that encompassed the entire lesions as well as an approximately 0.5cm rim of normal liver tissue. Results The procedures were successful and the patients recovered well without the complications of bleeding or bile leakage after mean 48-month follow up period. Spiral CT scanning showed that the contrast enhancement was disappeared within the lesions or at their periphery in all cases. The mean diameter of the ablated HCHs reduced 68%. Conclusion The results suggested that PRFA therapy was a minimally invasive, simple, safe, and effective approach for treating HCHs in selected patients.