Surgical Management for Symptomatic Giant Liver Hemangiomas: A Meta-Analysis.

OBJECTIVE

To conduct a meta-analysis of reported evidence on surgical management for symptomatic giant liver hemangiomas.

METHODOLOGY

A systematic literature search was conducted to identify studies on adult patient surgeries for symptomatic giant liver hemangiomas from January 2009 to July 2015. The primary outcome measures included postoperative symptom resolution, mortality, complications, and blood transfusions. Quality of life after surgery was taken as a secondary outcome. Meta-analysis was performed using a random-effect model with comprehensive meta-analysis software.

RESULTS

Fourteen studies with 1,557 patients were included. There were only two mortalities. Overall event rate for minor and major complications was low as 0.15 and 0.14, respectively, with a high symptom resolution rate of 0.69 (95%, CI 0.64-0.73). Pooled analysis for blood transfusion stayed insignificant due to high calculated heterogeneity across studies. Quality of life results after surgery are reported good by three studies, in most of their patients. The adverse outcome rate between enucleation and resection was comparable.

CONCLUSION

Liver hemangioma surgery is a safe treatment option with negligible mortality and low morbidity. It is effective in terms of symptom control and overall quality of life.