Research Article
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Year 2023, Volume: 14 Issue: 2, 119 - 124, 17.03.2023

Abstract

References

  • 1. Ishak KG, Rabin L. Benign tumors of the liver. Med Clin North Am. 1975; 59 (4): 995–1013.
  • 2. Hamaloglu E, Altun H, Ozdemir A, et al. Giant liver hemangioma: Therapy by enucleation or liver resection. World J Surg. 2005; 29 (7): 890–3.
  • 3. Clavien PA, Barkun J, de Oliveira ML, et al. The Clavien-Dindo classification of surgical complications. Ann Surg. 2009; 250 (2): 187–96.
  • 4. Agha R, Abdall-Razak A, Crossley E, et al. STROCSS 2019 Guideline: Strengthening the reporting of cohort studies in surgery. Int J Surg. 2019; 72: 156–65.
  • 5. Alper A. Treatment of liver hemangiomas by enucleation. Arch Surg. 1988; 123 (5):660.
  • 6. Nichols FC, van Heerden JA, Weiland LH. Benign liver tumors. Surg Clin North Am. 1989; 69 (2): 297–314.
  • 7. Liu Y, Wei X, Wang K, et al. Enucleation versus anatomic resection for giant hepatic hemangioma: A meta-analysis. Gastrointest Tumors. 2016; 3 (3–4): 153–62.
  • 8. Cheng W, Qi Y, Wang B, et al. Enucleation versus hepatectomy for giant hepatic haemangiomas: a meta-analysis. Ann R Coll Surg Engl. 2017; 99 (3): 237–41.
  • 9. Giuliante F, Ardito F, Vellone M, et al. Reappraisal of surgical indications and approach for liver hemangioma: Single-center experience on 74 patients. Am J Surg. 2011; 201 (6): 741–8.
  • 10. Zhang W, Huang Z-Y, Ke C-S, et al. Surgical treatment of giant liver hemangioma larger than 10 cm. Medicine. 2015; 94 (34): e1420.
  • 11. Croome KP, Yamashita MH. Laparoscopic vs open hepatic resection for benign and malignant tumors: An updated meta-analysis. Arch Surg. 2010; 145 (11): 1109–18.
  • 12. Lim KJ, Kim KW, Jeong WK, et al. Colour Doppler sonography of hepatic haemangiomas with arterioportal shunts. Br J Radiol. 2012; 85 (1010): 142–6.
  • 13. Tuxun T, Apaer S, Zhou C, et al. Surgery vs. observation for liver hemangioma: a systematic review and meta-analysis. Hepatogastroenterology. 2014; 61 (136): 2377–82.
  • 14. Schnelldorfer T, Ware AL, Smoot R, et al. Management of giant hemangioma of the liver: Resection versus observation. J Am Coll Surg. 2010; 211 (6): 724–30.
  • 15. Furumaya A, van Rosmalen BV, Takkenberg RB, et al. Transarterial (chemo-) embolization and lipiodolization for hepatic haemangioma. Cardiovasc Intervent Radiol. 2019; 42 (6): 800–11.
  • 16. Talebpour M, Zabihi-Mahmoudabadi H, Payandemehr P, et al. An effective method for controlling bleeding in a ruptured hepatic hemangioma: A case report. Adv J Emerg Med. 2018; 3 (1): e10.
  • 17. Torkian P, Li J, Kaufman JA, et al. Effectiveness of transarterial embolization in treatment of symptomatic hepatic hemangiomas: Systematic review and meta-analysis. Cardiovasc Intervent Radiol. 2021; 44 (1): 80–91.
  • 18. Gao J, Fan R-F, Yang J-Y, et al. Radiofrequency ablation for hepatic hemangiomas: A consensus from a Chinese panel of experts. World J Gastroenterol. 2017; 23 (39): 7077–86.
  • 19. Tang XY, Wang Z, Wang T, et al. Efficacy, safety and feasibility of ultrasound-guided percutaneous microwave ablation for large hepatic hemangioma. J Dig Dis. 2015; 16 (9): 525–30.
  • 20. Liu F, Yu X, Liang P, et al. Ultrasonography-guided percutaneous microwave ablation for large hepatic cavernous haemangiomas. Int J Hyperthermia. 2018; 34 (7): 1061–6.
  • 21. Tang X, Ding M, Lu B, et al. Outcomes of ultrasound-guided percutaneous microwave ablation versus surgical resection for symptomatic large hepatic hemangiomas. Int J Hyperthermia. 2019; 36 (1): 632–9.
  • 22. Biswal BM, Sandhu M, Lal P, et al. Role of radiotherapy in cavernous hemangioma liver. Indian J Gastroenterol. 1995; 14 (3): 95–8.
  • 23. Gaspar L, Mascarenhas F, Sáda Costa M, et al. Radiation therapy in the unresectable cavernous hemangioma of the liver. Radiother Oncol. 1993; 29 (1): 45–50.
  • 24. Prodromidou A, Machairas N, Garoufalia Z, et al. Liver transplantation for giant hepatic hemangioma: A systematic review. Transplant Proc. 2019; 51 (2): 440–2.

Surgical Approach in Liver Hemangiomas with Special Emphasis on Lesion Diameter and Type of Surgery: A Retrospective Cohort of 69 Patients

Year 2023, Volume: 14 Issue: 2, 119 - 124, 17.03.2023

Abstract

Purpose: Liver hemangioma (LH) being the most common benign tumor of the liver is a rare indication for liver surgery. Indications include symptomatic disease, diagnostic suspicion of malignancy, increase in lesion size, and Kasabach-Merritt syndrome. Surgical treatment mainly consists of enucleation or liver resection (LR). The study aimed to evaluate surgical outcomes in patients with LHs.
Methods: In this study, surgical treatment for liver hemangioma in a single center were retrospectively reviewed. Demographics, preoperative and postoperative laboratory values, imaging studies, and follow-up data of patients were collected.
Results: The mean age was 51.9±11.0 years and 69.6% were female. Abdominal pain was present preoperatively in 32 (46.4%) cases. Mean lesion diameter was 7.5 (1.2-20) cm. Giant hemangioma was reported in 54 (78.3%) patients. Liver resection (LR) and enucleation were preferred for 37 (53.6%) and 32 (46.4%) patients, respectively. Intraoperative transfusion requirement was more common in enucleation than LRs (78.1% vs. 48.6%, p=0.012). Intraoperative erythrocyte transfusion was more frequently in operations of giant hemangiomas (68.5% vs. 40.0%, p=0.044). Complications were observed more frequently in giant hemangioma group regardless of grades (40.7% vs. 13.3%, p=0.049). Preoperative thrombocytopenia was found more frequent in cases with serious complications (66.7% vs 22.2%, p=0.019).
Conclusion: Emerging percutaneous intervention and imaging modalities are expected to decrease number of surgeries for liver hemangiomas. Although enucleation, LR and even liver transplantation are still required for a set of patients. Enucleation and LR have similar outcomes, but transfusions are more common according to the present study. Size of LHs is related with complications and transfusion requirements.

References

  • 1. Ishak KG, Rabin L. Benign tumors of the liver. Med Clin North Am. 1975; 59 (4): 995–1013.
  • 2. Hamaloglu E, Altun H, Ozdemir A, et al. Giant liver hemangioma: Therapy by enucleation or liver resection. World J Surg. 2005; 29 (7): 890–3.
  • 3. Clavien PA, Barkun J, de Oliveira ML, et al. The Clavien-Dindo classification of surgical complications. Ann Surg. 2009; 250 (2): 187–96.
  • 4. Agha R, Abdall-Razak A, Crossley E, et al. STROCSS 2019 Guideline: Strengthening the reporting of cohort studies in surgery. Int J Surg. 2019; 72: 156–65.
  • 5. Alper A. Treatment of liver hemangiomas by enucleation. Arch Surg. 1988; 123 (5):660.
  • 6. Nichols FC, van Heerden JA, Weiland LH. Benign liver tumors. Surg Clin North Am. 1989; 69 (2): 297–314.
  • 7. Liu Y, Wei X, Wang K, et al. Enucleation versus anatomic resection for giant hepatic hemangioma: A meta-analysis. Gastrointest Tumors. 2016; 3 (3–4): 153–62.
  • 8. Cheng W, Qi Y, Wang B, et al. Enucleation versus hepatectomy for giant hepatic haemangiomas: a meta-analysis. Ann R Coll Surg Engl. 2017; 99 (3): 237–41.
  • 9. Giuliante F, Ardito F, Vellone M, et al. Reappraisal of surgical indications and approach for liver hemangioma: Single-center experience on 74 patients. Am J Surg. 2011; 201 (6): 741–8.
  • 10. Zhang W, Huang Z-Y, Ke C-S, et al. Surgical treatment of giant liver hemangioma larger than 10 cm. Medicine. 2015; 94 (34): e1420.
  • 11. Croome KP, Yamashita MH. Laparoscopic vs open hepatic resection for benign and malignant tumors: An updated meta-analysis. Arch Surg. 2010; 145 (11): 1109–18.
  • 12. Lim KJ, Kim KW, Jeong WK, et al. Colour Doppler sonography of hepatic haemangiomas with arterioportal shunts. Br J Radiol. 2012; 85 (1010): 142–6.
  • 13. Tuxun T, Apaer S, Zhou C, et al. Surgery vs. observation for liver hemangioma: a systematic review and meta-analysis. Hepatogastroenterology. 2014; 61 (136): 2377–82.
  • 14. Schnelldorfer T, Ware AL, Smoot R, et al. Management of giant hemangioma of the liver: Resection versus observation. J Am Coll Surg. 2010; 211 (6): 724–30.
  • 15. Furumaya A, van Rosmalen BV, Takkenberg RB, et al. Transarterial (chemo-) embolization and lipiodolization for hepatic haemangioma. Cardiovasc Intervent Radiol. 2019; 42 (6): 800–11.
  • 16. Talebpour M, Zabihi-Mahmoudabadi H, Payandemehr P, et al. An effective method for controlling bleeding in a ruptured hepatic hemangioma: A case report. Adv J Emerg Med. 2018; 3 (1): e10.
  • 17. Torkian P, Li J, Kaufman JA, et al. Effectiveness of transarterial embolization in treatment of symptomatic hepatic hemangiomas: Systematic review and meta-analysis. Cardiovasc Intervent Radiol. 2021; 44 (1): 80–91.
  • 18. Gao J, Fan R-F, Yang J-Y, et al. Radiofrequency ablation for hepatic hemangiomas: A consensus from a Chinese panel of experts. World J Gastroenterol. 2017; 23 (39): 7077–86.
  • 19. Tang XY, Wang Z, Wang T, et al. Efficacy, safety and feasibility of ultrasound-guided percutaneous microwave ablation for large hepatic hemangioma. J Dig Dis. 2015; 16 (9): 525–30.
  • 20. Liu F, Yu X, Liang P, et al. Ultrasonography-guided percutaneous microwave ablation for large hepatic cavernous haemangiomas. Int J Hyperthermia. 2018; 34 (7): 1061–6.
  • 21. Tang X, Ding M, Lu B, et al. Outcomes of ultrasound-guided percutaneous microwave ablation versus surgical resection for symptomatic large hepatic hemangiomas. Int J Hyperthermia. 2019; 36 (1): 632–9.
  • 22. Biswal BM, Sandhu M, Lal P, et al. Role of radiotherapy in cavernous hemangioma liver. Indian J Gastroenterol. 1995; 14 (3): 95–8.
  • 23. Gaspar L, Mascarenhas F, Sáda Costa M, et al. Radiation therapy in the unresectable cavernous hemangioma of the liver. Radiother Oncol. 1993; 29 (1): 45–50.
  • 24. Prodromidou A, Machairas N, Garoufalia Z, et al. Liver transplantation for giant hepatic hemangioma: A systematic review. Transplant Proc. 2019; 51 (2): 440–2.
There are 24 citations in total.

Details

Primary Language English
Subjects Surgery
Journal Section Research Article
Authors

Elvan Onur Kırımker 0000-0002-9890-9540

Süleyman Utku Çelik 0000-0002-1570-6327

Deniz Kütük 0000-0002-9084-4869

Şiyar Ersöz 0000-0003-1824-8453

Can Konca 0000-0001-6137-1946

Mehmet Ali Koç 0000-0002-4605-048X

Acar Tüzüner 0000-0002-5455-3239

Mehmet Kaan Karayalçın 0000-0002-8133-8040

Deniz Balcı 0000-0002-6246-1123

Publication Date March 17, 2023
Submission Date August 17, 2022
Published in Issue Year 2023Volume: 14 Issue: 2

Cite

EndNote Kırımker EO, Çelik SU, Kütük D, Ersöz Ş, Konca C, Koç MA, Tüzüner A, Karayalçın MK, Balcı D (March 1, 2023) Surgical Approach in Liver Hemangiomas with Special Emphasis on Lesion Diameter and Type of Surgery: A Retrospective Cohort of 69 Patients. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi 14 2 119–124.