Microwave ablation versus bleomycin-lipiodol emulsion with gelatin sponge embolization for hepatic hemangioma: efficacy and recovery outcomes in a retrospective cohort study.

Abstract

Objective: To compare the efficacy and postoperative recovery outcomes of microwave ablation (MWA) and transcatheter arterial embolization (TAE) using a bleomycin-lipiodol emulsion combined with gelatin sponge particles in the treatment of hepatic hemangioma.

Methods: In this retrospective study, 255 patients with hepatic hemangioma treated between January 2020 and June 2024 were analyzed. Patients were assigned to either the MWA group (n = 135) or the TAE group (n = 120). Evaluated parameters included operative characteristics, liver function changes, recovery metrics, complications, treatment efficacy, quality of life, and patient satisfaction.

Results: MWA resulted in a higher overall efficacy rate compared to TAE (76.30% vs. 61.67%, P = 0.011), but was associated with significantly elevated postoperative alanine aminotransferase (ALT) levels (P < 0.001), indicating greater hepatocellular injury. Although ablation procedures were longer (P = 0.005), they were associated with reduced intraoperative blood loss (P = 0.010). TAE was linked to faster recovery, reflected in shorter hospital stays (P = 0.003). The MWA group experienced fewer overall complications, though hemolysis was uniquely observed in this cohort. The TAE group had higher rates of fever and ischemic events. Both groups showed improved quality of life post-treatment, with the MWA group demonstrating greater gains in physical functioning (P = 0.004). Patient satisfaction was comparable between groups.

Conclusion: MWA and TAE are both effective treatment options for hepatic hemangioma, each with distinct advantages. MWA offers superior lesion control at the expense of greater hepatic stress, while TAE facilitates quicker recovery with a higher incidence of transient complications.