Terkivatan T, Vrijland W W, Den Hoed P T, De Man R A, Hussain S M, Tilanus H W, IJzermans J N M
Department of Surgery, University Hospital Rotterdam-Dijkzigt, Rotterdam, The Netherlands.
Br J Surg. 2002 Oct;89(10):1240-4. doi: 10.1046/j.1365-2168.2002.02219.x.
The unknown natural history and risk of complications of large haemangiomas may pose therapeutic dilemmas. The authors describe their experience with the management of giant haemangiomas.
Patients with a giant haemangioma were identified by a survey of the hospital database. Forty-nine patients with a haemangioma of at least 4 cm in diameter presented between January 1990 and December 2000. Medical records were analysed retrospectively.
Eleven patients had surgical treatment and 38 were managed conservatively. The median diameter of the tumours was 8.0 cm in surgically treated patients and 6.0 cm in the group managed by observation. Surgery-related morbidity occurred in three patients, and abdominal complaints persisted in three of ten patients with a symptomatic lesion. During a median follow-up of 52 months, 12 non-operated patients had mild abdominal complaints, considered to be unrelated to the lesion. In these patients symptoms either diminished or became minimal during follow-up. Complications did not occur.
Observation of giant haemangiomas can be performed safely. The authors advocate resection of cavernous liver haemangiomas only in patients with persistent severe symptoms.
大型血管瘤的自然病史不明且并发症风险可能带来治疗困境。作者描述了他们处理巨大血管瘤的经验。
通过医院数据库调查确定患有巨大血管瘤的患者。1990年1月至2000年12月期间，有49例直径至少4厘米的血管瘤患者。对病历进行回顾性分析。
11例患者接受了手术治疗，38例采取保守治疗。手术治疗患者的肿瘤中位直径为8.0厘米，观察组患者为6.0厘米。3例患者发生了与手术相关的并发症，10例有症状性病变的患者中有3例腹部不适持续存在。在中位随访52个月期间，12例未手术患者有轻度腹部不适，认为与病变无关。在这些患者中，症状在随访期间减轻或变得轻微。未发生并发症。
对巨大血管瘤进行观察可以安全地进行。作者主张仅对有持续严重症状的患者切除肝海绵状血管瘤。
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