A Study Of Superselective Transcatheter Arterial Embolization Combined With Surgery In The Treatment Of Giant Plexiform Neurofibroma

[Objective] Perioperative massive bleeding in giant plexiform neurofibroma makes surgery challenging,and various hemostatic methods can be used.This study was to investigate the efficacy of superselective transcatheter arterial embolization combined with surgical resection in the treatment of giant plexus neurofibroma.[Methods] From June 2013 to September 2021,a total of 26 patients with giant plexiform neurofibroma were chosen as the study object,of which 12 cases were treated by super-selective angiographic embolization(Arterial embolization group),and 14 cases underwent traditional hemostatic methods,such as suture,electrocoagulation,and tumescent anesthesia(Conventional treatment group).The two treatments were compared and analyzed from the aspects of perioperative blood loss,blood transfusion,operation time,complications,and quality of life.[Results] In the arterial embolization group,there were 5 males and 7 females,aged 10-50 years,with an average tumor area of 365.12cm2.Conventional treatment group: 4 males and 10 females,aged 8-42 years,average tumor area 225.09cm2;There was no significant difference in gender,age and tumor area between the two groups(P > 0.05).There were significant differences in perioperative blood loss,operation time and blood transfusion between the two groups(P < 0.05).The incidence of postoperative complications in the arterial embolization group was lower than that in the conventional treatment group(P=0.036).All patients were postoperatively monitored for at least 6 months,and all patients recovered well except one was found to have a recurrence.The quality of life of patients assessed by Peds QL neurofibromatosis Type 1 modular scale showed that the postoperative quality of life of patients in the arterial embolization group was significantly higher than that in the conventional treatment group(P < 0.001).[Conclusions] The results show that super-selective angiographic embolization can significantly reduce perioperative blood loss,reduce blood transfusion,shorten the operation time,reduce the incidence of complications,and improve the quality of life.Combined with surgical treatment for giant plexiform neurofibroma,super-selective angiographic embolization is safe and effective.