Loss M, Zülke C, Obed A, Stöltzing O, Schlitt H J
Klinik und Poliklinik für Chirurgie, Klinikum der Universität Regensburg, Franz-Josef-Strauss-Allee 11, 93053, Regensburg, Deutschland.
Chirurg. 2008 Aug;79(8):722-8. doi: 10.1007/s00104-008-1523-9.
Benign liver tumors are being detected more frequently due to the widespread use of ultrasound and complementary methods and due to improvements in diagnostic accuracy. In the case of a reliable diagnosis of asymptomatic hemangioma or focal nodular hyperplasia surgery is not indicated. Hepatic adenoma of considerable size should be resected primarily based on the risk of rupture. Improvements in diagnostic imaging as well as the optimization of surgical procedures with extremely low complication rates permit an individualized management strategy founded on evidence-based algorithms. In the case of an equivocal diagnosis, we advocate low-risk tumor resection instead of tumor biopsy due to the inherent complication rates of hemorrhage or tumor-cell dissemination and possible misleading histology.
由于超声及辅助检查方法的广泛应用以及诊断准确性的提高，良性肝肿瘤的检出率越来越高。对于无症状血管瘤或局灶性结节性增生的可靠诊断，无需手术治疗。较大的肝腺瘤应主要基于破裂风险进行切除。诊断成像技术的进步以及并发症发生率极低的手术方法的优化，使得基于循证算法的个体化管理策略成为可能。对于诊断不明确的情况，由于存在出血或肿瘤细胞播散的固有并发症发生率以及可能出现误导性组织学结果，我们主张进行低风险肿瘤切除而非肿瘤活检。
