Qureshi Sajid S, Bhagat Monica, Kembhavi Seema, Vora Tushar, Ramadwar Mukta, Chinnaswamy Girish, Prasad Maya, Khanna Nehal, Laskar Sidharth
Division of Pediatric Surgical Oncology, Department of Surgical Oncology, Tata Memorial Centre, Ernest Borges Road, Parel, Bombay, 400012, India.
Department of Radiology, Tata Memorial Centre, Bombay, India.
Pediatr Surg Int. 2015 Dec;31(12):1145-9. doi: 10.1007/s00383-015-3763-3. Epub 2015 Aug 12.
Benign liver tumors in children are rare and data regarding the surgical outcomes are deficient. We reviewed our experience in the management of these tumors particularly the extent, safety, and effectiveness of surgical resection.
Between March 2005 and March 2014, 10/90 liver resections were performed for benign liver tumors. Three other patients received conservative treatment. Demographic characteristics, operative management, morbidity, and mortality were analyzed.
The median age of the patients was 12 months. The distribution of pathology was infantile hepatic hemangioendothelioma/hemangioma (n = 7), mesenchymal hamartoma (n = 4), adenoma (n = 1) and focal nodular hyperplasia (n = 1). Median tumor size was 12.25 cm (range 3.5-21 cm) with a median tumor volume of 576.64 cm(3) (range 13.9-1822.64 cm(3)). Non-anatomic resection was performed in 6/10 patients and the median blood loss was 100 ml (range 10-850 ml). Median length of hospital stay was 7 days (range 5-9 days). There were no mortality, none of the patients had a local recurrence, and all are alive at a median follow-up of 33 months.
Two-third patients with benign liver tumors were managed with surgical excision, which comprised 11% of our resectional practice. Non-anatomical resection whenever feasible can be performed safely and does not compromise the oncological outcomes.
儿童良性肝肿瘤较为罕见,关于手术结果的数据也很缺乏。我们回顾了我们在这些肿瘤治疗方面的经验,特别是手术切除的范围、安全性和有效性。
2005年3月至2014年3月期间,90例肝脏切除手术中有10例是针对良性肝肿瘤进行的。另外3例患者接受了保守治疗。分析了患者的人口统计学特征、手术管理、发病率和死亡率。
患者的中位年龄为12个月。病理分布为婴儿型肝血管内皮瘤/血管瘤(n = 7)、间叶性错构瘤(n = 4)、腺瘤(n = 1)和局灶性结节性增生(n = 1)。肿瘤中位大小为12.25 cm(范围3.5 - 21 cm),中位肿瘤体积为576.64 cm³(范围13.9 - 1822.64 cm³)。10例患者中有6例进行了非解剖性切除,中位失血量为100 ml(范围10 - 850 ml)。中位住院时间为7天(范围5 - 9天)。无死亡病例,所有患者均无局部复发,在中位随访33个月时全部存活。
三分之二的良性肝肿瘤患者接受了手术切除,占我们肝脏切除手术量的11%。只要可行,非解剖性切除可以安全进行,且不影响肿瘤学结局。