• Acute kidney injury
• Hepatic hemangioma
• Microwave ablation

• Adult
• Aged
• Female
• Humans
• Male
• Middle Aged
• Acute Kidney Injury/etiology
• Acute Kidney Injury/therapy
• Hemangioma/surgery
• Liver Neoplasms/surgery
• Microwaves/adverse effects
• Microwaves/therapeutic use
• Perioperative Care/methods
• Postoperative Complications/therapy
• Postoperative Complications/etiology
• Radiofrequency Ablation/adverse effects
• Retrospective Studies

• atrial fibrillation
• hemolysis
• pulsed field ablation
• radiofrequency ablation

• Humans
• Female
• Atrial Fibrillation/surgery
• Male
• Middle Aged
• Hemolysis
• Aged
• Catheter Ablation/adverse effects
• Pulmonary Veins/surgery
• Radiofrequency Ablation/adverse effects
• Radiofrequency Ablation/methods
• Prospective Studies

• Benign
• Liver tumor
• Microwave ablation
• Radiofrequency ablation

• Coagulation
• Giant hepatic hemangioma
• Laparoscopic intratumoral resection
• Matched case–control study

Hepatic hemangioma is the most common benign tumor of the liver. However, patients with large hemangiomas that cause compression symptoms or that are at risk of rupture may need further intervention. It is necessary to explore additional minimally invasive and personalized treatment options for hemangiomas.

A 47-year-old woman was diagnosed with a right hepatic hemangioma for more than 10 years. Abdominal contrast-enhanced computed tomography (CT) and contrast-enhanced ultrasound revealed that there was a large hemangioma in the right liver, with a size of approximately 95 mm × 97 mm × 117 mm. Due to the patient's refusal of surgical treatment, hepatic artery embolization was performed in the first stage. After 25 d of liver protection treatment, the liver function indexes decreased to normal levels. Then, ultrasound-guided microwave ablation of the giant hepatic hemangioma was performed. Ten days after the treatment, hepatobiliary ultrasonography showed that the hemangioma of the right liver was smaller than the previous size (the volume was reduced by approximately 30%). Then the patient was discharged from the hospital. One year after discharge, CT showed that the hepatic hemangioma had shrunk by about 80%

Transcatheter arterial embolization combined with microwave ablation is a safe and effective minimally invasive treatment for hepatic hemangioma.

• Hepatic hemangioma
• Transcatheter arterial embolization
• Microwave ablation
• Minimally invasive treatment
• Case report

To report the complications of radiofrequency ablation (RFA) for hepatic hemangioma.

Investigators from six centers performed RFA for hepatic hemangioma and used a standardized follow-up protocol. Data were collected from 291 patients, including 253 patients with hepatic hemangioma 5 to 9.9 cm in diameter (group A) and 38 with hepatic hemangioma ≥ 10 cm (group B). Technical success, complete ablation, and complications attributed to the RFA procedure were reported. Analysis of variance was used to determine whether the major complication rate was related to tumor size or clinical experience.

A total of 304 lesions were treated in 291 patients. Technical success was achieved without adverse events in all cases. A total of 301 lesions were completely ablated, including 265 of 265 (100%) lesions in group A, and 36 of 39 (92.31%) in group B. The rate of technology-related complications was similar in groups A and B (5.14% (13/253) and 13.16% (5/38), respectively; P = 0.121). Moreover, all technology-related complications occurred during the early learning curve period. The rate of hemolysis-related complications in two groups were 83.40% (211/253) and 100% (38/38) (P =0.007) and the systemic inflammatory response syndrome-related complications in two groups were 33.99% (86/253) and 86.84% (33/38) (P<0.001). There were no delayed complications in either group.

RFA is minimally invasive, safe, and effective for hepatic hemangiomas 5 to 9.9 cm in diameter. More clinical data are needed to confirm the safety of RFA for hepatic hemangiomas ≥ 10 cm.

• complication
• hepatic hemangioma
• multicenter
• radiofrequency ablation (RFA)
• safety

• Hepatic hemangioma
• Laparoscopic hepatectomy
• Open hepatectomy
• Prognosis

• Blood Loss, Surgical
• Hemangioma/surgery
• Hepatectomy/adverse effects
• Humans
• Laparoscopy/adverse effects
• Length of Stay
• Liver Neoplasms/surgery
• Postoperative Complications/etiology
• Retrospective Studies
• Treatment Outcome

• Hemangioma
• Liver
• Proton beam therapy
• Radiotherapy
• Secondary cancer

• Hepatic hemangioma
• feeding artery
• minimally invasive treatment
• radiofrequency ablation
• ultrasound guidance

• Hepatic hemangioma
• Liver
• Liver masses
• Vascular lesion

• Catheter Ablation/methods
• Embolization, Therapeutic/methods
• Hemangioma/pathology
• Hemangioma/therapy
• Hepatectomy/methods
• Humans
• Internal Medicine
• Liver Neoplasms/pathology
• Liver Neoplasms/therapy

To evaluate the value of a three dimension (3D)visualization operative planning system in ultrasound-guided percutaneous microwave ablation (US-PMWA) for large hepatic hemangiomas (LHHs).

Fifty-eight patients with LHHs were divided into 3D and 2D groups. The therapeutic efficacy was assessed by contrast-enhanced imaging during follow-up. Hepatic and renal function were examined. The complete ablation, tumor volume shrinkage, and complication rates were analyzed.

The ablation time and energy of the 3D group were lower than those of the 2D group (1152.0 ± 403.9 s vs. 1379.7 ± 375.8 s and 87,407.2.9 ± 50,387.0 J vs. 117,775.8 ± 46,245.6 J, P = 0.031 and 0.021, respectively). The 3D group had a higher complete ablation rate than the 2D group (97.7 ± 2.4% vs. 94.5 ± 3.7%, P < 0.001). The incidence of hemoglobinuria after ablation in the 3D group was lower than that in the 2D group (32.0% vs. 57.6%, P = 0.047). The levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and creatinine (Cre) after ablation in the 3D group were lower than those in the 2D group (126.7 ± 56.4 U/L vs. 210.9 ± 96.2 U/L, P < 0.001; 141.0 ± 60.8 U/L vs. 211.4 ± 90.0 U/L, P = 0.001; 57.3 ± 17.6 U/L vs. 80.8 ± 41.9 U/L, P = 0.010; and 66.6 ± 16.6 mmol/L vs. 84.5 ± 39.6 mmol/L, P = 0.037, respectively). There were no significant differences in antenna insertion and the volume reduction rate between the groups. One patient developed acute kidney injury shortly after ablation in the 2D group and recovered after hemodialysis. No other severe complications occurred during the follow-up period.

The 3D visualization operative planning system has a relatively high clinical application value in providing scientific, reasonable, quantifiable, and individualized therapy for LHHs by US-PMWA.

• 3D visualization operative planning system
• Large hepatic hemangiomas
• Microwave ablation

• Giant hepatic hemangioma
• efficacy
• microwave ablation
• safety
• ultrasound-guided

• hemoglobinuria
• hepatic cavernous hemangioma
• microwave ablation
• risk factors
• ultrasound guidance

• ALPPS
• FLR hypertrophy
• Intrahepatic split
• Major hepatectomy
• Microwave ablation
• Portal vein embolization

Recent studies have shown that radiofrequency (RF) ablation therapy is a safe, feasible, and effective procedure for hepatic hemangiomas, even huge hepatic hemangiomas. RF ablation has the following advantages in the treatment of hepatic hemangiomas: minimal invasiveness, definite efficacy, high safety, fast recovery, relatively simple operation, and wide applicability. It is necessary to formulate a widely accepted consensus among the experts in China who have extensive expertise and experience in the treatment of hepatic hemangiomas using RF ablation, which is important to standardize the application of RF ablation for the management of hepatic hemangiomas, regarding the selection of patients with suitable indications to receive RF ablation treatment, the technical details of the techniques, therapeutic effect evaluations, management of complications, etc. A final consensus by a Chinese panel of experts who have the expertise of using RF ablation to treat hepatic hemangiomas was reached by means of literature review, comprehensive discussion, and draft approval.

• Hepatic hemangiomas
• Radiofrequency ablation
• Consensus

• Catheter Ablation/adverse effects
• Catheter Ablation/mortality
• China
• Consensus
• Hemangioma/mortality
• Hemangioma/pathology
• Hemangioma/surgery
• Humans
• Liver Neoplasms/mortality
• Liver Neoplasms/pathology
• Liver Neoplasms/surgery
• Postoperative Complications/etiology
• Risk Factors
• Treatment Outcome

Traditionally, open hepatic resection is the first choice of treatment for symptomatic enlarging hepatic hemangiomas, which requires a large abdominal incision and is associated with substantial recovery time and morbidity. Minimally invasive laparoscopic resection has been used recently in liver surgery for treating selected hepatic hemangiomas. However, laparoscopic liver surgery poses the significant technical challenges and high rate of conversion. Radiofrequency (RF) ablation has been proved feasible in the treatment of hepatic hemangiomas with a size range of 5.0-9.9 cm. It is controversial to treat giant hepatic hemangiomas (≥10.0 cm) by means of RF ablation, due to the low technique success rate and high incidence of ablation-related complications. We aimed to assess the safety and efficacy of combined laparoscopic resection with intratumoral RF-induced coagulation for giant hepatic hemangiomas.

We treated 2 patients with giant subcapsular hepatic hemangioma (12.0 cm and 13.1 cm in diameters respectively) by laparoscopic resection following intratumoral coagulation of the tumor with RF ablation.

Blood loss during resection was 100 ml (case 1) and 300ml (case 2) respectively. No blood transfusion and dialysis were needed during perioperative period. The two patients were discharged 6 days (case 1) and 12 days (case 2) after surgery without any complications, respectively. Postoperative contrast-enhanced CT follow up showed there was no residual tumor.

It is feasible to treat giant subcapsular hepatic hemangioma by laparoscopic tumor resection boosted by intratumoral coagulation using RF ablation, which may open a new avenue for treating giant hemangioma.

• giant hepatic hemangioma
• laparoscopy
• radiofrequency ablation
• resection