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Comparison of laparoscopic radiofrequency ablation versus open resection in the treatment of symptomatic-enlarging hepatic hemangiomas: a prospective study

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Abstract

Background

Radiofrequency ablation (RFA) has been demonstrated to be a promising therapy for symptomatic large hepatic hemangioma. However, there is a lack of studies to demonstrate the benefits and disadvantages of RFA as compared with surgical resection for managing hepatic hemangioma. The aim of this study was to evaluate the outcomes of RFA compared with conventional open resection (ORES) for the treatment of symptomatic-enlarging hepatic hemangiomas.

Methods

A total of 66 patients with symptomatic-enlarging hepatic hemangiomas (4 cm ≤ diameter < 10 cm) who required surgical treatment were divided into two groups: 32 patients underwent laparoscopic radiofrequency ablation (LRFA) and the other 34 patients underwent ORES. We compared the two groups in terms of radiologic response, clinical response, operative time, estimated blood loss, postoperative pain score and analgesic requirement, length of hospital stay, postoperative complications and hospital cost.

Results

The radiologic and clinical responses were comparable between groups. LRFA had significantly shorter operative time (138 vs. 201 min, P < 0.001) and less blood loss (P < 0.001) than ORES. Patients after LRFA experienced significantly less pain and required less analgesia use. Moreover, patients underwent LRFA had significantly shorter length of hospital stay (P < 0.001) and lower hospital cost (P = 0.017). No severe morbidities or mortality was observed, and the overall morbidity rate was similar between groups.

Conclusions

As a new minimal invasive treatment option, laparoscopic radiofrequency ablation is as safe and effective a procedure as open resection for patients with symptomatic-enlarging hepatic hemangiomas smaller than 10 cm.

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Abbreviations

RFA:

Radiofrequency ablation

LRFA:

Laparoscopic radiofrequency ablation

PRFA:

Percutaneous radiofrequency ablation

ORFA:

Open radiofrequency ablation

ORES:

Open resection

TAE:

Transcatheter arterial embolization

LC:

Laparoscopic cholecystectomy

CT:

Computed tomography

MRI:

Magnetic resonance imaging

PCIA:

Patient-controlled intravenous analgesia

TB:

Total bilirubin

ALT:

Alanine aminotransferase

AST:

Aspartate aminotransferase

POD:

Postoperative day

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Acknowledgments

This study was supported by a grant from the National Science and Technology Major Project of China (2012ZX10002-016 and 2012ZX10002-017).

Disclosures

Xiaowu Zhang, Lunan Yan, Bo Li, Tianfu Wen, Wentao Wang, Mingqing Xu, Yonggang Wei and Jiayin Yang have no conflict of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Hepatic Surgery, Liver Transplantation Center, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan Province, China

    Xiaowu Zhang, Lunan Yan, Bo Li, Tianfu Wen, Wentao Wang, Mingqing Xu, Yonggang Wei & Jiayin Yang

  2. Department of Regenerative Medicine Research Center, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, Sichuan Province, China

    Xiaowu Zhang

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  1. Xiaowu Zhang
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  2. Lunan Yan
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  3. Bo Li
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  5. Wentao Wang
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  6. Mingqing Xu
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Correspondence to Jiayin Yang.

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Zhang, X., Yan, L., Li, B. et al. Comparison of laparoscopic radiofrequency ablation versus open resection in the treatment of symptomatic-enlarging hepatic hemangiomas: a prospective study. Surg Endosc 30, 756–763 (2016). https://doi.org/10.1007/s00464-015-4274-y

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  • DOI: https://doi.org/10.1007/s00464-015-4274-y

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