Research Article
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
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.
Keywords
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 | |
| Publication Date | March 17, 2023 |
| Submission Date | August 17, 2022 |
| Published in Issue | Year 2023Volume: 14 Issue: 2 |
