What are the minimally invasive interventions for common benign diseases

We will introduce the minimally invasive interventional treatment methods for several common diseases and their comparison with common methods. 1.Hepatic hemangioma: Hepatic hemangioma is the most common benign tumor of the liver. Generally speaking, treatment is only considered for hemangiomas of at least 5 cm. The common treatment method is open (or laparoscopic) partial hepatectomy. Its advantages are: maximum complete resection of the tumor and low chance of recurrence after surgery; its disadvantages are: large surgical trauma, different size and location of the tumor, different postoperative effects on liver function, and strict requirements for the patient’s age and other basic conditions. Interventional treatment of hepatic hemangioma is performed by placing a drug injection catheter in the blood supply artery of hepatic hemangioma through arterial puncture and injecting iodized oil and other drugs into the blood supply artery to block the blood supply to the tumor and “starve” the tumor. Its advantages are: small trauma (only a ball-point pencil wound at the root of the thigh), no abdomen opening, no liver incision, tumor size has little influence on the treatment method, fast postoperative recovery, within a certain range, other medical diseases have little influence on the treatment, repeatability, and no significant increase in the difficulty of interventional treatment after recurrence; its disadvantages are: the tumor is not completely removed from the body, for larger tumors, embolization needs to be performed in stages, and postoperative monitoring is required. The disadvantages are: the tumor is not completely removed from the body, embolization is needed for larger tumors, and tumor changes need to be monitored after surgery. 2.Uterine fibroids: Uterine fibroids are the most common benign tumors in gynecology. They are classified into subplasma, submucosal and interstitial myomas. The common treatment methods are total hysterectomy and myomectomy. The advantages are: the tumor tissue is removed and pathological examination is feasible to exclude the possibility of malignancy. The disadvantages are: it is more traumatic and requires open abdomen (or laparoscopy), total hysterectomy is not only the uterus itself, but also may have psychological impact on some patients, and myomectomy, although the uterus is not removed, there is some damage to the uterine wall, and if the fibroid recurs, the previous operation will have some impact on the second open abdomen (or laparoscopy) operation. Interventional treatment of uterine fibroids is performed through arterial puncture and embolization of uterine arteries with embolic agents such as PVA microspheres to block the blood supply to the tumor and “starve” the tumor. The uterus itself can continue to maintain its own school supply through the establishment of other pelvic vascular branches. The advantages of this procedure are: small trauma (only a ball-point pencil wound at the base of the thigh), no abdominal opening, the size of the tumor has little influence on the treatment method, fast recovery, within a certain range, other internal diseases have little influence on the treatment, reproducibility, and preservation of the uterus, an important part of the female reproductive system. The disadvantages are: it is only suitable for interstitial fibroids (most uterine fibroids are interstitial fibroids), and the tumor tissue cannot be removed for pathological examination (there are fewer cases of malignant fibroids or preoperative misdiagnosis of malignant as benign). Adenomyosis: It is a benign disease that is difficult to be completely cured in the field of gynecology. The common treatment method is drug therapy, and total hysterectomy should be considered when drug therapy is not effective. Interventional treatment of adenomyosis is also done through arterial puncture and embolization of uterine arteries with embolic agents such as PVA microspheres to block the blood supply to the uterus. Since the blood supply to the ectopic endometrium is richer than that to the uterine smooth muscle (which can be roughly understood as the uterine wall), ischemic atrophy of the ectopic endometrium between the smooth muscle after embolization can relieve the patient’s symptoms. The advantages are: less invasive, more reproducible, more effective than drug therapy alone, and preservation of the uterus, an important component of the female reproductive system. It can be used as an alternative treatment between drug therapy and hysterectomy; its shortcomings are: this method still cannot cure the disease, and there is a possibility of recurrence after surgery. 4. Primary hyperthyroidism (hyperthyroidism): a common endocrine disease. Common treatment methods are: drug therapy, radioactive iodine therapy and surgical subtotal thyroidectomy. All three methods are classical methods of treatment for hyperthyroidism and have obvious effects when applied rationally. Interventional treatment of primary hyperthyroidism is to block part of the blood supply to the thyroid gland by selective embolization of the superior thyroid artery, causing partial atrophy and dysfunction of the gland, thereby reducing the production and secretion of thyroxine. The advantages of this procedure are that it is less invasive and the extent and degree of embolization can be controlled intraoperatively according to the imaging; the disadvantages of this procedure are that it is risky and not suitable for everyone.