METHOD FOR CHOOSING THE TACTICS OF MANAGEMENT OF PATIENTS WITH LIVER HEMANGIOMAS AT THE STAGE OF SURGICAL TREATMENT WITH INDICATIONS FOR EMBOLIZATION OF THE FETAL VESSEL

摘要

FIELD: medicine, lever surgery in particular.;SUBSTANCE: invention relates to medicine, namely to minimally invasive liver surgery. Ultrasound examination is performed and the size of the hemangioma is determined. If the diameter of the hemangioma of the right lobe of the liver is from 5 to 10 cm, then ultrasound is performed for the patient with contrast and the time of accumulation of contrast in the tumor tissue in the arterial phase, the time of removal from the tumor tissue in the venous and delayed phases is determined. Arteriovascular embolization is performed. The next day after embolization, a second ultrasound with contrast is performed and the stagnation of arterial blood flow is determined in comparison with the initial one. With stagnation of 70% or more, the surgical stage of treatment is considered complete. With stagnation from 30 to 70% and embolization with spiral emboli, radiofrequency thermal ablation is performed, and in other cases, open resection is performed. The method makes it possible to increase the effectiveness of treatment of patients with liver hemangiomas, to reduce the frequency of open resection interventions and the development of serious postoperative complications, to reduce the duration of hospital stay and mortality in this category of patients. ;EFFECT: method makes it possible to increase the effectiveness of treatment of patients with hepatic hemangiomas, primarily due to the use of insufficient stagnation of blood flow according to ultrasound studies with contrast performed on the next day after arteriovascular embolization compared to the initial values of one of the modern minimally invasive methods of local destruction, thus reducing the need for open resection interventions, and, accordingly, reduce the number of postoperative complications, hospital bed days, mortality in this category of patients. ;1 cl, 3 ex