Local suture ligation-assisted percutaneous sclerotherapy for Kasabach-Merritt phenomenon-associated kaposiform haemangioendothelioma
Local suture ligation-assisted percutaneous sclerotherapy for Kasabach-Merritt phenomenon-associated kaposiform haemangioendothelioma
复制标题
局部缝合结扎辅助经皮硬化治疗卡萨巴赫-梅里特现象相关的卡波西样血管内皮瘤
DOI：
10.3892/ol.2018.9661
复制
发表时间：
2019-01-01
期刊：
影响因子：
2.9
通讯作者：
Fan，Xin-Dong
中科院分区：
文献类型：
--
作者：
Li，Xiao;Wen，Ming-Zhe;Fan，Xin-Dong
Kaposi型血管内皮瘤(KHEs)合并Kasabach-Merritt现象(KMP)是一种罕见的严重肿瘤性病变，常伴有局部侵袭性疾病、消耗性凝血障碍和高死亡率。目前的治疗方案尚未取得令人满意的治疗效果。因此，对于复杂的KHE/KMP病例，一种有效且微创的治疗方法对于临床治疗是必要的。本病例系列描述了接受局部缝合结扎辅助经皮硬化治疗的KHE/KMP患者，以最大限度地减少手术创伤并确保有效治疗。自2015年9月至2017年9月，连续3例KHE/KMP患者接受了分期局部缝线结扎辅助经皮硬化治疗。在这些患者中，2例有皮质类固醇治疗的病史，但结果不令人满意。这些患者接受了包括经皮硬化治疗和辅助药物治疗的逐步综合系列治疗方案，同时还进行了缝线结扎术。分析临床、放射学、病理和实验室资料以评估治疗结果。所有患者均成功地接受了建议的手术。临床症状明显缓解，血液学指标明显改善。术后定期随访(4、19、28个月)未见复发或并发症。总之，局部缝线结扎辅助经皮硬化治疗KHE/KMP是一种安全有效的治疗方法，创伤小，操作简单，在某些病例中具有明显的治疗优势。需要进行更大样本量的进一步研究，以彻底评估该方法，这可能被用作KHE/KMP治疗的一种新的治疗选择。
Kaposiform haemangioendotheliomas (KHEs) complicated by the Kasabach-Merritt phenomenon (KMP) are rare and severe neoplastic lesions often associated with locally aggressive disease, consumption coagulopathy and high mortality rates. Current regimens have yet to achieve a satisfactory therapeutic effect. Thus, an effective and minimally invasive approach for treating complex KHE/KMP cases is necessary for clinical management. The present case series describes patients with KHE/KMP who underwent local suture ligation-assisted percutaneous sclerotherapy to minimise surgical trauma and ensure effective treatment. Between September 2015 and September 2017, 3 consecutive patients with KHE/KMP underwent staged local suture ligation-assisted percutaneous sclerotherapy. Of these patients, 2 presented with medical histories of corticosteroid treatment with unsatisfactory outcomes. The patients underwent a stepwise synthetic serial therapy programme consisting of percutaneous sclerotherapy and adjunctive pharmacotherapy accompanied by a suture ligation procedure. Clinical, radiological, pathological and laboratory data were analysed to evaluate the outcomes of the therapy. All patients were successfully managed with the proposed procedure. Significant relief of clinical symptoms and improvements in haematological indicators were achieved. No recurrence or complications were observed during regular follow-up (4, 19 and 28 months). In conclusion, local suture ligation-assisted percutaneous sclerotherapy was demonstrated to be a safe and effective treatment for KHE/KMP, being minimally invasive, involving simple manipulation and providing a clear treatment benefit in certain cases. Further studies involving larger sample sizes are required to thoroughly evaluate the procedure, which can potentially be used as a novel therapeutic option for KHE/KMP treatment.