Hoffmann Katrin, Unsinn Michael, Hinz Ulf, Weiss Karl Heinz, Waldburger Nina, Longerich Thomas, Radeleff Boris, Schirmacher Peter, Büchler Markus W, Schemmer Peter
Department of General and Transplant Surgery, University Hospital Heidelberg, Heidelberg, Germany.
Internal Medicine IV, University Hospital Heidelberg, Heidelberg, Germany.
HPB (Oxford). 2015 Nov;17(11):994-1000. doi: 10.1111/hpb.12496. Epub 2015 Sep 3.
Benign liver tumours represent a challenge in clinical management. There is considerable controversy with respect to the indications for surgery as the evidence for surgical treatment is variable. The aim of this retrospective study was to analyse the indication and outcome after resection of benign, solid liver lesions.
Data of 79 patients, who underwent liver resection between 2001 and 2012, were analysed for demographic and outcome parameters.
Thirty-eight patients with focal nodular hyperplasia (48%), 23 patients with haemangioma (29%) and 18 patients with hepatocellular adenoma (23%) underwent a hepatic resection. A major hepatic resection was performed in 23 patients (29%) and a minor resection in 56 patients (71%). The post-operative mortality rate was zero and the 30-day morbidity rate 13.9%. After a median follow-up of 64 months, 75 patients (95%) were alive, and no patient had developed recurrent disease. Fifty-four patients (68%) were pre-operatively symptomatic, of which, 87% had complete or partial relief of symptoms after a liver resection. The incidence of symptoms increased with the lesions' size.
The management of benign liver lesions necessitates an individualized therapy within a multidisciplinary, evidence-based, treatment algorithm. Resection of benign liver lesions can be performed safely in well-selected patients without mortality and low post-operative morbidity.
肝脏良性肿瘤在临床管理中是一项挑战。关于手术指征存在相当大的争议,因为手术治疗的证据并不一致。这项回顾性研究的目的是分析良性实性肝脏病变切除术后的指征和结果。
分析了2001年至2012年间接受肝脏切除术的79例患者的人口统计学和结果参数。
38例局灶性结节性增生患者(48%)、23例血管瘤患者(29%)和18例肝细胞腺瘤患者(23%)接受了肝脏切除术。23例患者(29%)进行了大肝切除术,56例患者(71%)进行了小肝切除术。术后死亡率为零,30天发病率为13.9%。中位随访64个月后,75例患者(95%)存活,无患者出现复发性疾病。54例患者(68%)术前有症状,其中87%在肝脏切除术后症状完全或部分缓解。症状发生率随病变大小增加而升高。
肝脏良性病变的管理需要在多学科、基于证据的治疗方案内进行个体化治疗。在精心挑选的患者中,良性肝脏病变切除术可以安全进行,无死亡率且术后发病率低。