介入栓塞联合射频消融治疗肝巨大局灶性结节性增生的疗效评价

Evaluation of transcatheter arterial embolization combined with radiofrequency ablation for treatment of huge focal nodular hyperplasia of liver

  • 摘要: 目的 探讨介入栓塞术联合腹腔镜辅助超声引导下射频消融术治疗肝巨大局灶性结节性增生的可行性、安全性及有效性。 方法 纳入本院肝胆外科2015年4月-2017年6月连续收治的肝巨大局灶性结节样增生患者7例,男性3例,女性4例,年龄19 ~ 45岁,肿瘤大小10 ~ 13 cm,所有患者采用介入栓塞术联合超声引导下射频消融术治疗,观察围术期情况及长期疗效。 结果 7例手术均先行经股动脉造影超选瘤体供血动脉使用明胶海绵及碘油行介入栓塞术,2 ~ 7 d后行腹腔镜辅助超声引导射频消融术,保证消融范围内温度高于90℃,手术全部成功。围术期2例出现术区疼痛,均无大出血、胆漏、肠瘘等严重并发症。术后2 ~ 3 d CT检查提示消融区完全覆盖肿瘤位置,随访6个月~ 2年未发现肿瘤复发或残余。 结论 介入栓塞术联合腹腔镜辅助超声引导下射频消融术治疗肝巨大局灶性结节性增生安全、有效。

     

    Abstract: Objective To investigate the feasibility, safety and effectiveness of transcatheter arterial embolization (TAE) combined with laparoscopic ultrasound guided radiofrequency ablation (RFA) for the treatment of huge focal nodular hyperplasia (FNH)of the liver. Methods From April 2015 to June 2017, a total of 7 patients with huge FNH who were treated in the department of hepatobiliary surgery in Chinese PLA General Hospital were enrolled in this study. There were 3 males and 4 females with age ranged from 19 to 45 years old and tumor size of 10-13 cm. All patients were treated by TAE combined with laparoscopic ultrasound guided RFA and they were followed up for 6 months to 2 years. The perioperative condition and long-term outcome were observed. Results All the 7 patients had undergone TAE combined with laparoscopic ultrasound guided RFA successfully. No serious complications such as bleeding, bile leakage and intestinal fistula was observed. Computed tomography (CT) examination at 2-3 days after RFA revealed that the ablation region completely covered the lesion. There was no tumor recurrence or residual signs during the follow-up. Conclusion TAE combined with laparoscopic ultrasound guided RFA is safe and effective for the treatment of huge FNH of the liver.

     

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