Comparison of the clinical efficacy of laparoscopic microwave ablation and laparoscopic hepatectomy in the treatment of hepatic hemangioma
10.3760/cma.j.cn113884-20240627-00191
- VernacularTitle:腹腔镜微波消融术与腹腔镜肝切除术治疗肝血管瘤的临床疗效比较
- Author:
Wenzhou DING
1
;
Litao LIANG
;
Deming ZHU
;
Lianbao KONG
;
Yongping ZHOU
Author Information
1. 南京医科大学第一附属医院肝胆中心 中国医学科学院肝移植重点实验室 国家卫生健康委活体肝移植重点实验室，南京 210029
- Keywords:
Laparoscopes;
Microwave ablation;
Laparoscopic hepatectomy;
Hepatic hemangioma
- From:
Chinese Journal of Hepatobiliary Surgery
2024;30(11):819-823
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare and analyze the clinical efficacy of laparoscopic microwave ablation and laparoscopic hepatectomy in the treatment of hepatic hemangioma.Methods:The clinical data of 98 patients with hepatic hemangioma admitted to the Hepatobiliary Center, the First Affiliated Hospital of Nanjing Medical University from June 2019 to June 2023 were retrospectively analyzed, including 20 males and 78 females, aged 24-69 years. According to the surgical method, they were divided into two groups: laparoscopic microwave ablation group (ablation group) with 34 cases, and laparoscopic hepatectomy group (resection group) with 64 cases. The differences in intraoperative and postoperative recovery related indicators, follow-up and prognosis between the two groups were compared and analyzed.Results:The operative time and blood loss in the ablation group were (90.6±21.8) min and (60.3±40.8) ml, respectively, which were lower than those in the resection group (128.7±30.0) min and (165.8±212.7) ml, and the differences were statistically significant ( t=-6.54, -2.86, P<0.001, P=0.005). There were 5 cases (14.71%) of residual lesions in the ablation group and none in the resection group, with a significant difference between the two groups ( χ2=0.01, P=0.003). The ablation group was superior to the resection group in hospital stay, drainage tube removal time and postoperative pain, with statistical significance (all P<0.05). On the 1st and 3rd day after surgery, the levels of alanine aminotransferase, aspartate aminotransferase, total bilirubin and direct bilirubin in ablation group were lower than those in resection group, and the differences were statistically significant (all P<0.05). In the ablation group, there were 14 cases of hemoglobinuria (41.2%), 2 cases of abdominal hemorrhage (5.9%), 0 cases of bile leakage and 6 cases of pleural effusion (17.7%), while in the resection group, these complications were 2 cases (3.1%), 18 cases (28.1%), 11 cases (17.2%) and 32 cases (50.0%), respectively, and there were statistical significance between the two groups (all P<0.05). In terms of prognosis, there was both one recurrence in each group (2.9% vs. 1.6%), with no significant difference ( χ2=1.00, P=0.653). Conclusion:Compared with laparoscopic hepatectomy, laparoscopic microwave ablation has obvious advantages in terms of operation time, intraoperative blood loss, hospital stay, postoperative pain and complications.
