Clinical Application Of Percutaneous Fractionated Microwave Ablation In The Spleen For Treatment Of Hypersplenism

Objective: The purpose of this study is to investigate the efficacy and safety of percutaneousfractionated microwave (MW) ablation of spleen for the treatment of hypersplenism.Methods: Forty-one patients with secondary hypersplenism resulting from liver cirrhosis weretreated with MW ablation of splenic parenchyma percutaneously. First ablated one third of thewhole spleen volume, and then ablated another one third after one week. Routine blood counts(PLT, WBC, and RBC), liver function, portal vein diameter, splenic vein and blood flow wereexamined before and after MW ablation. Complications were observed after treatment.Results: After MW ablation, PLT count and WBC count increased dramatically, with follow-upfor24months, the levels of PLT and WBC were significantly higher than those before ablation(both P <0.05); There were no significant improvements in RBC count and liver functionparameters after MW ablation (P>0.05); The diameter of the portal vein narrowed and theblood flow velocity of the portal vein increased significantly at3months after MW ablation,compared with the condition before ablation, there were statistical differences.At6months,theywere basicly returned to the preoperative levels, compared with those preoperative values, therewere no statistically significant difference (P>0.05);The diameter of the splenic vein narrowed,the blood flow velocity of the splenic vein significantly reduced postoperative, compared withthose preoperative values,there were still statistical differences at24months after MWablation (P<0.05). There were no severe complications such as uncontrollable bleeding withmedical treatment,splenic abscess, spleen rupture and the surrounding organ damage.Theadverse effects were fever(100%),transient hemoglobinuria（100%）,left upper abdominal or leftshoulder pain（63.4%）,pleural effusion（26.8%）and so on,which recovered smoothly or withsymptomatic treatments.Conclusion: Percutaneous fractionated microwave (MW) ablation can damage enough spleenvolume safely and effectively, PLT count and WBC count increased obviously, portalhypertension improved and no serious complications occurred. It can serve as a new, promisingminimally invasive technique for the treatment of hypersplenism.