A matched case ⁃ control study and literature review comparing laparoscopic microwave ablation and laparoscopic hepatectomy for the treatment of giant hepatic hemangioma
Objective:To compare the clinical outcome and literature review of laparoscopic microwave ablation and laparoscopic hepatectomy for the treatment of giant hepatic hemangioma,and explore the treatment strategiesgiant hepatic hemangioma. Method: From January 2020 to December 2022,a total of 18 patientsdiagnosed with giant hepatic hemangiomaunderwent laparoscopic vascular tumor microwave ablation at the First Affiliated Hospital of Nanjing Medical University. Based on the size,location,and body mass index of the hemangioma,18 patients who underwent laparoscopic hemangioma resection duringthe same period were selected for a 1∶ 1 matched case-control study. The surgical duration,intraoperative blood loss,postoperative complications,postoperative hospital stay, andpostoperative liver function[alanine transaminase(ALT),aspartate transaminase(AST),and total bilirubin(TBIL)]on the first day were compared between two groups of patients,as well as the short -term and long -term complicationsand prognosis. Results:The surgical duration in the laparoscopic microwave ablation group was shorter than that in the laparoscopic surgery group(P < 0.001),the intraoperative blood loss was lower than that in the laparoscopic surgery group(P < 0.001),and the postoperative hospital stay was shorter than that in the laparoscopic surgery group(P < 0.001). There were no significant difference in the incidence of postoperative adverse reaction(P > 0.05),postoperative liver function on the first day after surgery(ALT,AST,TBIL,P > 0.05)between the two groups. No midium-term or long-term complications were observedduring the follow-up period after surgery in both groups. Conclusion:Laparoscopic microwave ablation is an effective and safe treatment for giant liverhemangioma,and it can significantly reduce intraoperative blood loss,surgical duration,and postoperative hospital stay.