Surgical resection is a traditional treatment for hepatic hemangioma, which has many disadvantages, such as large trauma, potential complica
Surgical resection is a traditional treatment for hepatic hemangioma, which has many disadvantages, such as large trauma, potential complications and limited application. Over the past 10 years, some Department of hepatobiliary surgery experts committed to clinical application of radiofrequency ablation for hepatic hemangioma, with satisfactory achievements, put forward the radiofrequency ablation of hepatic hemangioma can be used as the preferred treatment and other important points, and summed up a series of security policy. Relevant results published in the "surgical" and "clinical gastroenterology" magazine, shows that the research achievements in this field are widely recognized by international peers.
A liver hemangioma if the volume is greater than 5 cm, and the growth tendency is obvious, the need for active treatment
Liver hemangioma is the most common benign tumor of the liver, most of the liver hemangioma diameter less than 5 cm, and slow growth, no special treatment, regular observation can be. If the hemangioma is greater than 5 cm in diameter, and the tumor growth trend is obvious, or the tumor increases to produce abdominal pain, bloating and other symptoms, need active treatment.
Two, the traditional surgical resection of trauma, potential complications, clinical application is limited
In the past, surgical resection is the only treatment for hepatic hemangioma. The incidence of complications of surgical treatment of hepatic hemangioma was 27%, and the fatality rate was as high as 3%. For benign disease, surgical treatment has such a high incidence of complications and mortality, so that clinicians and patients are difficult to easily accept. In the past ten years, surgeons in the Department of surgery and interventional therapy have been trying to apply the method of radiotherapy and transcatheter arterial embolization in the treatment of hepatic hemangioma. But these two kinds of local treatment may cause intrahepatic bile duct injury, ectopic embolism, radioactive hepatitis and veno occlusive disease and other serious complications, contrary to minimally invasive treatment concept, difficult to be widely accepted.
Three, radiofrequency ablation minimally invasive, safe and effective, can be used as the first choice for treatment of liver hemangioma
Radiofrequency ablation is a minimally invasive treatment of liver malignant tumor is one of the commonly used, early cancer cure means, the main principle is to produce sufficient heat by radiofrequency current, the tumor tissue coagulative necrosis. In the past ten years, radiofrequency ablation has been used in the treatment of hepatic hemangioma.
In the literature, 10 cases were treated with radiofrequency ablation (RFA), which was more than 5 cm to 10 cm. In 2011, in an article published in the Journal of Hepatology, radiofrequency catheter ablation was performed in 20 patients with giant hemangioma and in the presence of 5 giant hepatic hemangiomas. Results: of the 5 giant hepatic hemangiomas, there were no treatment failures. Therefore, the authors suggest that radiofrequency ablation is not suitable for the treatment of giant hepatic hemangioma. We treated before 2010 were reviewed, the results show that the radiofrequency ablation is a safe and effective treatment of hepatic hemangioma, but the treatment of giant hepatic hemangioma, although the treatment effect is satisfactory, but the complication rate is high, of course, these complications are caused because of the first to carry out the work of the lack of experience. The study was published in the famous American Journal of surgery.
The lack of regular physical examination in patients with hepatic hemangioma in China is often the development of a huge tumor, the clinical symptoms can be diagnosed, which is significantly different from the developed countries. Giant hemangioma of the liver, and often due to the huge tumor, the risk of surgery, doctors and patients is usually a push to push again, delayed the best treatment time. From this point of view, giant hepatic hemangioma is a kind of disease that needs to carry out minimally invasive treatment. Our team in previous work on the basis of the radiofrequency ablation in the treatment of giant hepatic hemangioma complications had many problems to research; by changing the treatment philosophy and improve treatment strategies, enhance the ablation equipment, significantly reduced the ablation related complications. First, in the treatment of giant hepatic hemangioma, in the light of the characteristics of benign disease, no longer required to achieve a one-time complete ablation, if necessary, repeat radiofrequency ablation strategy. Second, put forward a series of strategies including: ablation electrode after ablation of normal liver tissue in liver hemangioma, appropriate to extend the first ablation time point, the "first point edge, after the center of the ablation strategy, laparoscopic path blocking the first hepatic portal blood flow interruption. Third, compare the various ablation electrodes, we believe that the cold, straight needle ablation electrode design because of its function of concentration, no tissue around the needle, and so on, is more suitable for the treatment of hepatic hemangioma. The work won the international peer recognition, was published in the American Journal of clinical gastroenterology. "".
In conclusion, the principle of the treatment of hepatic hemangioma is changing from the traditional surgical treatment to the minimally invasive treatment with radiofrequency ablation.