Retrospective Single-Arm Cohort Study of Patients with Hepatocellular Adenomas Treated with Percutaneous Thermal Ablation
Retrospective Single-Arm Cohort Study of Patients with Hepatocellular Adenomas Treated with Percutaneous Thermal Ablation
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DOI：
10.1007/s00270-018-1893-4
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发表时间：
2018-06-01
影响因子：
2.9
通讯作者：
Kachura, John R.
中科院分区：
文献类型：
--
作者：
Mironov, Oleg;Jaberi, Arash;Kachura, John R.
Purpose To assess the safety and efficacy of percutaneous thermal ablation for the treatment of hepatocellular adenomas.Materials and Methods这是一项伦理委员会批准的、单臂、回顾性、队列研究，研究对象为1999年至2016年在三级转诊中心接受经皮热消融治疗的经病理证实的肝细胞腺瘤患者。收集人口统计学、手术和结局数据，并采用适当的集中趋势和离散度指标进行总结。根据介入放射学会报告指南对并发症进行分级。主要和次要技术疗效的确定是基于术后imaging.Results 36例患者（4男，32女），中位年龄为35岁，有44个程序的58个肿瘤的治疗。22%的患者既往有腺瘤相关出血史。中位肿瘤大小为2.1 cm（范围0.6-6.0）。大多数治疗是在门诊进行的，在中度镇静下，使用超声引导下的射频消融术。中位手术时间为85分钟。有2例术后即刻再狭窄（每例手术4.5%）。中位随访时间为1.7年（95% CI 0.2-8.0），未发生恶性转化、腺瘤相关性复发或死亡。结论热消融治疗肝细胞腺瘤的一级有效率为88%，二级有效率为100%。主要并发症发生率为4.5%。中位随访1.7年的临床疗效为100%。
Purpose To assess the safety and efficacy of percutaneous thermal ablation for the treatment of hepatocellular adenomas.Materials and Methods This is an ethics board-approved, single-arm, retrospective, cohort study of patients with pathologically proven hepatocellular adenomas treated with percutaneous thermal ablation at a tertiary referral center from 1999 to 2016. Demographic, procedural, and outcome data were collected and summarized with appropriate measures of central tendency and dispersion. Complications were graded per the Society of Interventional Radiology reporting guidelines. Determination of primary and secondary technique efficacies was based on post-procedural imaging.Results Thirty-six patients (4 male, 32 female) with a median age of 35 years had 44 procedures for the treatment of 58 tumors. Twenty-two percent of patients had prior history of adenoma-related hemorrhage. The median tumor size was 2.1 cm (range 0.6-6.0). The majority of treatments were done on an outpatient basis, under moderate sedation, using radiofrequency ablation with ultrasound guidance. The median procedure time was 85 min. There were two immediate post-procedural hemorrhages (4.5% per procedure). During a median follow-up of 1.7 years (95% CI 0.2-8.0), there were no instances of malignant transformation, adenoma-related hemorrhages, or deaths. The primary and secondary technique efficacy rates were 88 and 100%, respectively.Conclusion Thermal ablation for the treatment of hepatocellular adenoma had a primary and secondary efficacy of 88 and 100%, respectively. The major complication rate was 4.5%. The clinical efficacy during a median follow-up of 1.7 year was 100%.