Investigation of Three-Step Radiofrequency Ablation in Treatment for Giant Hepatic Hemangioma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LiuHui , ZhangXi , TanYun-hua , FengXiao-bin , YanJun ,  MaKuan-sheng

Institute of Hepatobiliary Surgery, Southwest Hospital, The Third Military Medical University, Chongqing 400038, China;

Corresponding?author：

MaKuan-sheng, Email: makuansheng@vip.sina.com

Keywords：

Giant hepatic hemangioma; Radiofrequency ablation; Three-step method; Efficacy; Safety

DOI：

10.7507/1007-9424.20160043

Video：

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Objective To investigate efficacy and safety of three-step radiofrequency ablation (RFA) in treatment for giant hepatic hemangioma (GHH,diameter ≥5 cm) with symptoms. Methods The patients with GHH met the inclusion criteria were collected.The main steps were as follows:The first step was to destroy the main arteries of the tumor to block the blood.The second step was to withdraw the blood of the tumor to shrink the tumor.The third step was to damage the shrunk tumor by RFA. Results There were 13 patients with GHH met the inclusion criteria.The median preoperative diameter was 8.0 cm.The median volume of withdrawing blood was 78 mL.The median diameter after withdrawing blood was 5.3 cm.The diameters between after and before withdrawing blood had a significant difference (P<0.01).The time for damaging tumor blood supply was (4.4±1.0) min.The median frequency of tumor RFA was 4 times.The median time of tumor RFA was 16 min.The median time of total operation was 20 min.There were 3 cases of tumor residual after RFA,10 cases were met full damage,and the damage rate was 85.9%-100% with an average of 97.0%.The hospital stay after RFA was (3.9±1.2) d.One case was remission after conservative treatment because of complication. Conclusion The preliminary results of limited cases in this study show that three-step RFA for GHH is effective and safe,but it needs to be researched for large samples data.

Citation： LiuHui, ZhangXi, TanYun-hua, FengXiao-bin, YanJun, MaKuan-sheng. Investigation of Three-Step Radiofrequency Ablation in Treatment for Giant Hepatic Hemangioma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(2): 160-163. doi: 10.7507/1007-9424.20160043 Copy

1.	?Ishak KG, Rabin L. Benign tumors of the liver. Med Clin North Am, 1975, 59(4):995-1013.
2.	Hoekstra LT, Bieze M, Erdogan D, et al. Management of giant liver hemangiomas:an update. Expert Rev Gastroenterol Hepatol, 2013, 7(3):263-268.
3.	Kumashiro Y, Kasahara M, Nomoto K, et al. Living donor liver transplantation for giant hepatic hemangioma with Kasabach-Merritt syndrome with a posterior segment graft. Liver Transpl, 2002, 8(8):721-724.
4.	Meguro M, Soejima Y, Taketomi A, et al. Living donor liver transp-lantation in a patient with giant hepatic hemangioma complicated by Kasabach-Merritt syndrome:report of a case. Surg Today, 2008, 38(5):463-468.
5.	Yoon SS, Charny CK, Fong Y, et al. Diagnosis, management, and outcomes of 115 patients with hepatic hemangioma. J Am Coll Surg, 2003, 197(3):392-402.
6.	Herman P, Costa ML, Machado MA, et al. Management of hepatic hemangiomas:a 14-year experience. J Gastrointest Surg, 2005, 9(6):853-859.
7.	Demircan O, Demiryurek H, Yagmur O. Surgical approach to symp-tomatic giant cavernous hemangioma of the liver. Hepatogastroen-terology, 2005, 52(61):183-186.
8.	耿小平. 肝血管瘤外科治療的現狀、問題和看法. 國際外科學雜志, 2007, 34(2):73-75.
9.	Pietrabissa A, Giulianotti P, Campatelli A, et al. Management and follow-up of 78 giant haemangiomas of the liver. Br J Surg, 1996, 83(7):915-918.
10.	Brouwers MA, Peeters PM, De Jong KP, et al. Surgical treatment of giant haemangioma of the liver. Br J Surg, 1997, 84(3):314-316.
11.	Charny CK, Jarnagin WR, Schwartz LH, et al. Management of 155 patients with benign liver tumours. Br J Surg, 2001, 88(6):808-813.
12.	Yamamoto T, Kawarada Y, Yano T, et al. Spontaneous rupture of hemangioma of the liver:treatment with transcatheter hepatic arterial embolization. Am J Gastroenterol, 1991, 86(11):1645-1649.
13.	Biswal BM, Sandhu M, Lal P, et al. Role of radiotherapy in cavernous hemangioma liver. Indian J Gastroenterol, 1995, 14(3):95-98.
14.	Hashimoto M, Sugawara M, Ishiyama K, et al. Reduction in the size of a hepatic haemangioma after chemotherapy. Liver Int, 2008, 28(7):1043-1044.
15.	馬慶久, 李席如, 杜錫林, 等. B超引導下射頻熱毀損治療肝臟海綿狀血管瘤. 第四軍醫大學學報, 2000, 21(11):1409.
16.	Monchik JM, Donatini G, Iannuccilli J, et al. Radiofrequency ablation and percutaneous ethanol injection treatment for recurrent local and distant well-differentiated thyroid carcinoma. Ann Surg, 2006, 244(2):296-304.
17.	Van Tilborg AA, Nielsen K, Scheffer HJ, et al. Bipolar radiofrequency ablation for symptomatic giant (>10 cm) hepatic cavernous haeman-giomas:initial clinical experience. Clin Radiol, 2013, 68(1):e9-e14.
18.	Toro A, Mahfouz AE, Ardiri A, et al. What is changing in indica-tions and treatment of hepatic hemangiomas. A review. Ann Hepatol, 2014, 13(4):327-339.
19.	Cui Y, Zhou LY, Dong MK, et al. Ultrasonography guided percuta-neous radiofrequency ablation for hepatic cavernous hemangioma. World J Gastroenterol, 2003, 9(9):2132-2134.
20.	Park SY, Tak WY, Jeon SW, et al. The efficacy of intraperitoneal saline infusion for percutaneous radiofrequency ablation for hepa-tocellular carcinoma. Eur J Radiol, 2010, 74(3):536-540.
21.	Nam SY, Rhim H, Kang TW, et al. Percutaneous radiofrequency ablation for hepatic tumors abutting the diaphragm:clinical assess-ment of the heat-sink effect of artificial ascites. AJR Am J Roentgenol, 2010, 194(2):W227-W231.
22.	孔健, 高君, 王劭宏, 等. 肝血管瘤射頻消融致嚴重溶血和明顯腎功能損害一例. 中華普通外科雜志, 2010, 25(8):691-692.
23.	Park SY, Tak WY, Jung MK, et al. Symptomatic-enlarging hepatic hemangiomas are effectively treated by percutaneous ultrasono graphy-guided radiofrequency ablation. J Hepatol, 2011, 54(3):559-565.
24.	Yamamoto K, Itoshima T, Ito T, et al. Scanning electron microscopy of a liver cavernous hemangioma. Gastroenterol Jpn, 1983, 18(1):15-20.
25.	趙仲蓉, 李國威, 王寶太, 等. 肝臟巨大海綿狀血管瘤碘油栓塞治療及其血供研究. 中華放射學雜志, 1994, 28(7):472-475.
26.	李國威, 陳啟龍, 陳革. 肝海綿狀血管瘤血供來源研究方法的討論. 肝膽外科雜志, 2000, 8(3):199-201.
27.	鄒華, 閆軍, 吳艷霞, 等. 加強型射頻消融新技術治療巨大肝血管瘤. 中華肝臟病雜志, 2012, 20(4):261-265.

1. ?Ishak KG, Rabin L. Benign tumors of the liver. Med Clin North Am, 1975, 59(4):995-1013.
2. Hoekstra LT, Bieze M, Erdogan D, et al. Management of giant liver hemangiomas:an update. Expert Rev Gastroenterol Hepatol, 2013, 7(3):263-268.
3. Kumashiro Y, Kasahara M, Nomoto K, et al. Living donor liver transplantation for giant hepatic hemangioma with Kasabach-Merritt syndrome with a posterior segment graft. Liver Transpl, 2002, 8(8):721-724.
4. Meguro M, Soejima Y, Taketomi A, et al. Living donor liver transp-lantation in a patient with giant hepatic hemangioma complicated by Kasabach-Merritt syndrome:report of a case. Surg Today, 2008, 38(5):463-468.
5. Yoon SS, Charny CK, Fong Y, et al. Diagnosis, management, and outcomes of 115 patients with hepatic hemangioma. J Am Coll Surg, 2003, 197(3):392-402.
6. Herman P, Costa ML, Machado MA, et al. Management of hepatic hemangiomas:a 14-year experience. J Gastrointest Surg, 2005, 9(6):853-859.
7. Demircan O, Demiryurek H, Yagmur O. Surgical approach to symp-tomatic giant cavernous hemangioma of the liver. Hepatogastroen-terology, 2005, 52(61):183-186.
8. 耿小平. 肝血管瘤外科治療的現狀、問題和看法. 國際外科學雜志, 2007, 34(2):73-75.
9. Pietrabissa A, Giulianotti P, Campatelli A, et al. Management and follow-up of 78 giant haemangiomas of the liver. Br J Surg, 1996, 83(7):915-918.
10. Brouwers MA, Peeters PM, De Jong KP, et al. Surgical treatment of giant haemangioma of the liver. Br J Surg, 1997, 84(3):314-316.
11. Charny CK, Jarnagin WR, Schwartz LH, et al. Management of 155 patients with benign liver tumours. Br J Surg, 2001, 88(6):808-813.
12. Yamamoto T, Kawarada Y, Yano T, et al. Spontaneous rupture of hemangioma of the liver:treatment with transcatheter hepatic arterial embolization. Am J Gastroenterol, 1991, 86(11):1645-1649.
13. Biswal BM, Sandhu M, Lal P, et al. Role of radiotherapy in cavernous hemangioma liver. Indian J Gastroenterol, 1995, 14(3):95-98.
14. Hashimoto M, Sugawara M, Ishiyama K, et al. Reduction in the size of a hepatic haemangioma after chemotherapy. Liver Int, 2008, 28(7):1043-1044.
15. 馬慶久, 李席如, 杜錫林, 等. B超引導下射頻熱毀損治療肝臟海綿狀血管瘤. 第四軍醫大學學報, 2000, 21(11):1409.
16. Monchik JM, Donatini G, Iannuccilli J, et al. Radiofrequency ablation and percutaneous ethanol injection treatment for recurrent local and distant well-differentiated thyroid carcinoma. Ann Surg, 2006, 244(2):296-304.
17. Van Tilborg AA, Nielsen K, Scheffer HJ, et al. Bipolar radiofrequency ablation for symptomatic giant (>10 cm) hepatic cavernous haeman-giomas:initial clinical experience. Clin Radiol, 2013, 68(1):e9-e14.
18. Toro A, Mahfouz AE, Ardiri A, et al. What is changing in indica-tions and treatment of hepatic hemangiomas. A review. Ann Hepatol, 2014, 13(4):327-339.
19. Cui Y, Zhou LY, Dong MK, et al. Ultrasonography guided percuta-neous radiofrequency ablation for hepatic cavernous hemangioma. World J Gastroenterol, 2003, 9(9):2132-2134.
20. Park SY, Tak WY, Jeon SW, et al. The efficacy of intraperitoneal saline infusion for percutaneous radiofrequency ablation for hepa-tocellular carcinoma. Eur J Radiol, 2010, 74(3):536-540.
21. Nam SY, Rhim H, Kang TW, et al. Percutaneous radiofrequency ablation for hepatic tumors abutting the diaphragm:clinical assess-ment of the heat-sink effect of artificial ascites. AJR Am J Roentgenol, 2010, 194(2):W227-W231.
22. 孔健, 高君, 王劭宏, 等. 肝血管瘤射頻消融致嚴重溶血和明顯腎功能損害一例. 中華普通外科雜志, 2010, 25(8):691-692.
23. Park SY, Tak WY, Jung MK, et al. Symptomatic-enlarging hepatic hemangiomas are effectively treated by percutaneous ultrasono graphy-guided radiofrequency ablation. J Hepatol, 2011, 54(3):559-565.
24. Yamamoto K, Itoshima T, Ito T, et al. Scanning electron microscopy of a liver cavernous hemangioma. Gastroenterol Jpn, 1983, 18(1):15-20.
25. 趙仲蓉, 李國威, 王寶太, 等. 肝臟巨大海綿狀血管瘤碘油栓塞治療及其血供研究. 中華放射學雜志, 1994, 28(7):472-475.
26. 李國威, 陳啟龍, 陳革. 肝海綿狀血管瘤血供來源研究方法的討論. 肝膽外科雜志, 2000, 8(3):199-201.
27. 鄒華, 閆軍, 吳艷霞, 等. 加強型射頻消融新技術治療巨大肝血管瘤. 中華肝臟病雜志, 2012, 20(4):261-265.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Investigation of Three-Step Radiofrequency Ablation in Treatment for Giant Hepatic Hemangioma

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