Laparoscopic microwave ablation for hepatic hemangiomas with different locations: A comparative study

Figure 1 Schematic diagram illustrating microwave ablation of a hepatic hemangioma. The image shows a microwave electrode inserted into the hemangioma and the generated heat distribution. It depicts heat transfer along the portal vein and heat accumulation within surrounding blood. During the ablation process, the heat from the vessel’s spreads to other liver segments, causing thermal damage to the liver and the accumulation of heat leading to intravascular hemolysis. A channel pre-drilled near the ablation point, known as the gas-blood outflow channel, is conducive to the outflow of hot oxygen bubbles and blood. The image created by FigDraw (Supplementary material).

Figure 2 A total of 180 patients who underwent trans-arterial embolization + laparoscopic microwave ablation surgery for hepatic hemangioma were included in this study. After screening, 28 patients who did not meet the criteria were excluded. Among them, 12 had other benign liver diseases, and the other 16 had partial data missing. Ultimately, 152 patients were randomly assigned to the giant hepatic hemangioma (HH) group (72 cases) and the large HH group (80 cases). Specifically, the giant HH group included 55 cases of liver subcapsular of the liver and 17 instances of lesions within the liver parenchymal. In the large HH group, there were 63 cases of liver subcapsular of the liver and 17 instances of lesions within the liver parenchymal. This study aims to conduct a comparative analysis of the liver and kidney functions, coagulation functions, inflammatory indicators, perioperative indicators, and complications of these two groups of patients after surgery. TAE: Trans-arterial embolization; LMWA: Laparoscopic microwave ablation; GHH: Giant hepatic hemangioma; LHH: Large hepatic hemangioma.

Figure 3 Establishment of the gas-blood outflow channel. A: Prior to the initiation of each microwave ablation cycle, a gas-blood outflow channel is created using a standard microwave ablation needle. The specific depth of this channel is determined based on the maximum diameter of the hemangioma as measured from preoperative imaging, rather than a fixed length, to ensure tailored channel placement according to individual tumor characteristics (the depth is approximately half of the maximum diameter of the tumor); B: The blood flowing out of the channel, and the thermal oxygen bubbles caused by the heat conduction effect are observed.