Analysis of the efficacy and safety of splenic artery balloon occlusion combined with splenic microwave ablation in the treatment of hepatocellular carcinoma complicated with cirrhosis and hypersplenism
10.3760/cma.j.cn113884-20240826-00256
- VernacularTitle:脾动脉球囊阻断联合脾脏微波消融治疗肝癌合并肝硬化脾功能亢进的疗效与安全性分析
- Author:
Xin GAO
1
;
Yanmei OU
;
Yong XU
;
Lei ZHANG
;
Huikai LI
;
Tongguo SI
;
Mao YANG
;
Shuncai ZHANG
;
Xing LI
Author Information
1. 天津市肿瘤医院空港医院超声诊疗科，天津 300000
- Publication Type:Journal Article
- Keywords:
Hypersplenism;
Thrombocytopenia;
Microwave ablation;
Splenic artery occlusion
- From:
Chinese Journal of Hepatobiliary Surgery
2025;31(1):49-53
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the efficacy and safety of splenic artery occlusion combined with microwave ablation (MWA) in the treatment of hepatocellular carcinoma (HCC) complicated with liver cirrhosis and hypersplenism.Methods:Clinical data of 24 patients with HCC complicated with cirrhosis and secondary hypersplenism admitted to Airport Hospital of Tianjin Cancer Hospital from August 2023 to May 2024 were retrospectively analyzed, including 13 males and 11 females, aged (57.4±7.8) years. All patients were treated with splenic artery occlusion combined with MWA of spleen. Spleen volume measured by MRI before and after MWA, blood routine changes and postoperative complications (fever, bleeding, pain, renal failure and thrombosis) were analyzed.Results:The splenic volume of 24 patients measured by MRI before MWA was 692.4 (504.7, 1023.7) cm 3, and decreased to 225.0 (186.4, 285.6) cm 3 after treatment for 60 days ( Z=-3.23, P=0.001). The red blood cell counts were comparable before and after microwave ablation. The white blood cell count before MWA was 4.3 (3.2, 5.3)×10 9/L, which increased to 11.0 (8.6, 15.8)×10 9/L three days after treatment, and to 5.0 (3.3, 6.1)×10 9/L 90 days after treatment ( Z=-4.70, -0.34, P<0.001, P=0.732). The platelet count of the patients was 47.0 (39.0, 67.0)×10 9/L before MWA, which increased to 155.0 (120.3, 214.3)×10 9/L seven days after Treatment, and to 77.0 (63.0, 125.0)×10 9/L 90 days after treatment ( Z=-5.29, -2.51, P<0.001, P=0.012). None of the patients had obvious bleeding and no death occured. One patient (4.2%) developed renal failure, one patient (4.2%) had splenic venous thrombosis, 4 patients (16.7%) had pain of different degrees, and 5 patients (20.8%) had low fever. Conclusion:Splenic artery occlusion combined with MWA in the treatment of HCC complicated with liver cirrhosis and hypersplenism can significantly reduce spleen volume and increase platelet level with acceptable complications.
