| Background:Transarterial sclerosing embolization(abbreviated as TASE thereafter)and surgical resection are the two most common measures to treat symptomatic hemangioma of liver(abbreviated as SCHL thereafter).TASE means to inject Pingyangmycin-Lipiodol Emulsion(abbreviated as PLE thereafter)into feeding artery of CHL by arterial catheter,perhaps accompanied by embolization with some solid embolic agents.At present.there are few studies on the long term follow-up with respect to therapeutic effect and complications of surgical operation and PLE-TASE.According to some limited literature,PLE-TASE has a good treatment effect in the short term,but a higher recurrence rate in the long term and some serious postoperative complications.This study aims to evaluate the long-term therapeutic effect and safety of the two treatment on the SCHL patients through more than 10 years follow-up..Objective:This study aim to evaluating therapeutic effect and safety of upper two treatment measures in the long term.Methods:According to our inclusion and exclusion criteria,there was a total of 146 cases incorporated in this research from a retrospective collection of 253 patients who received the PLE-TASE(named as embolization group thereafter)and surgical resection(named as Operation Group thereafter)in our hospital from 2000 January to 2010 December.There were 57 males and 89 females.The average age was 44.7±9.1 years old.The preoperative liver function of all patients was Child-puhgA.The embolization group patients had received the PLE-TASE,and the operation group patients had received hepatic segment or lobe resection.After above operation,all the patients received treatment of transvenousliver protection medicine and nutrition as well as symptomatic treatment.We has analyzed statistically the tumor reduction degree and differences in blood routine,liver function and coagulation function between embolization group and operation group,and observed the symptom relief degree and whether complications occur in the long term.Result:In this study,96 patients were visited,of which 7 died from causes unrelated to the disease,so 89 patients were visited successfully and the follow-up failure rate 10 years after operation was 34.2%.51 cases of embolization group had received PLETASE treatment,of who were 21 male patients and 30 female patients,at an average age of 43.1±8.8 years old.Before the treatment,their average maximum tumor diameter was 8.7±4.9 cm.According to the DSA diagnosis,the embolization group of 51 cases was divided into rich-blood sinus group with 35 cases,and poor-blood sinus group with 16 cases.The other 38 patients had received surgical operation treatment,consisting of 14 male patients and 24 female patients,at an average of 41.3±6.0 years old,whose average maximum tumor diameter was 6.9±3.0 cm before operation.The clinical baseline date,of gender,age,location and the number of lesions,and preoperative maximum tumor diameter and so no,of two group were proved to show no difference by independent sample t-test,chi-square test and Fisher exact test,which show the clinical comparability,The mean follow-up time was 145.2 months(range,108-209 months)±26.3 months.all patients of the two groups have obtained symptom of SCHL remission.The total symptom remission rate was 100%.The anxiety relief rate of 34 anxiety type CHL patients was 100%.In general,the average rate of tumor reduction for more than 10 years was 72.7±30.0%,which was 69.2±31.6%for embolization Group and 79.4±22.3%for operation Group.The independent-samples T test shows that the differences of tumor reduction rate over 10 years between the two Group was insignificant(the T value is 1.184,P=0.242).The tumor reduction rate over 10 years was 80.0±24.1%for poor-blood sinus Group and 44.3±33.9%for poorblood sinus group,and the independent-samples T test showed that the difference of tumor reduction rate over 10 years between the two groups was significant(the value of T is 3.449,P=0.002).The pared-samples T test showed that the difference was insignificant after comparing the blood routine before operation and that over 10 years after operation of embolization Group(the value of T was 0.476,0.675 and 0.563,respectively,and the P value was 0.699,0.132 and 0.456,respectively).The difference was insignificant after comparing the liver function and coagulation function over 10 years before operation and that after operation of embolization Group(the value of T was 0.564,1.231 and 0.675,respectively,and P=0.564,0.875 and 0.543).The paredsamples T test showed that the difference of WBC,PLT and HGB was insignificant after comparing the blood routine before operation and that over 10 years after operation(the value of T was 0.638,0.268 and 1.268,respectively,and the value of P was 0.675,0.278 and 0.682,respectively),and the differences of TBIL,ALB and PT was insignificant after comparing the liver function and coagulation function before operation and that over 10 years after operation(the T value is 2.129,0.278 and 0.378,respectively,and the value of P was 0.281,0.682 and 0.675,respectively).Comparing the blood routine over 10 years after the treatment between the embolization group and operation group,it was found that the differences of WBC,PLT and HGB between the two groups was insignificant,and the analysis of covariance showed that the differences of change was insignificant(the value of F was 0.267,0.267 and 0.721,respectively,and the value of P was 0.627,0.168 and 0.682,respectively).Comparing the liver function and coagulation function over 10 years after the treatment between the embolization group and operation group,it was found that the differences of TBIL,ALB and PT was also insignificant(the value of F was 0.628,0.572 and 0.682,respectively,and the value of P was 0.681,0.682 and 0.291,respectively).Conclusion:PLE-TASE is an effective treatment for CHL.There was no significant difference between the two treatment of PLE-TASE and surgical resection on the tumor reduction rate more than 10 years after treatment.Angiographic classification had could influence on the tumor reduction rate more than 10 years after PLE-TASE treatment significantly.The tumor reduction rate of rich blood sinus group patients was higher than that of poor blood sinus group,and the difference was significant.Surgical resection and PLETASE treatment had no significant effect on liver function and blood routine in the long term. |
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