Hau Hans-Michael, Kloss Anne, Wiltberger Georg, Jahn Nora, Krenzien Felix, Benzing Christian, Schmelzle Moritz, Seehofer Daniel, Atanasov Georgi, Bartels Michael
Department of Visceral, Transplantation, Vascular and Thoracic Surgery, University Hospital of Leipzig, Germany.
Department of Anesthesiology and Intensive Care Medicine, University of Leipzig Medical Faculty, Leipzig, Germany.
Z Gastroenterol. 2017 Jul;55(7):639-652. doi: 10.1055/s-0043-110145. Epub 2017 Jul 14.
Due to improved diagnostical and therapeutical approaches, benign liver tumors represent a challenge in clinical management. We here report our experience with patients undergoing liver resection for benign liver tumors. 188 One hundred eighty-eight consecutive patients, who underwent surgery for solid benign liver tumors from 1992 - 2014, were analyzed retrospectively. The focus was on diagnostic pathways, indications for surgery, and perioperative and postoperative quality of life (QoL). Of 188 patients, 100 had focal nodular hyperplasia (FNH) (53.2 %), 33 had hepatocellular adenoma (17.5 %), and 55 had hemangioma (29.3 %). In most patients, there was more than one 1 indication for liver resection, including tumor-associated symptoms (n = 82, 43.6 %), suspicion of malignancy (n = 104, 55.3 %), tumor disease in the medical history (n = 48, 25.5 %), or tumor enlargement (n = 27, 14.4 %). Serious complications (>grade III;, Clavien-Dindo) occurred in 9.5 % of patients. Perioperative mortality was 0.5 %. Patient pain scores decreased over time (p < 0.001). QoL after liver resection significantly improved (p = 0.007). Uncertainty of the tumor entity remains an issue in preoperative diagnostics. If indicated, liver resection for benign liver tumors represents a safe approach and leads to significant improvements of QoL.
由于诊断和治疗方法的改进，良性肝肿瘤在临床管理中成为一项挑战。我们在此报告对接受肝切除治疗良性肝肿瘤患者的经验。对1992年至2014年期间连续188例接受实性良性肝肿瘤手术的患者进行了回顾性分析。重点在于诊断途径、手术指征以及围手术期和术后生活质量（QoL）。188例患者中，100例患有局灶性结节性增生（FNH）（53.2%），33例患有肝细胞腺瘤（17.5%），55例患有血管瘤（29.3%）。大多数患者有不止一项肝切除指征，包括肿瘤相关症状（n = 82，43.6%）、怀疑恶性肿瘤（n = 104，55.3%）、病史中有肿瘤疾病（n = 48，25.5%）或肿瘤增大（n = 27，14.4%）。9.5%的患者发生严重并发症（>III级，Clavien-Dindo）。围手术期死亡率为0.5%。患者疼痛评分随时间下降（p < 0.001）。肝切除术后生活质量显著改善（p = 0.007）。肿瘤实体的不确定性在术前诊断中仍然是一个问题。如果有指征，良性肝肿瘤的肝切除是一种安全的方法，并能显著改善生活质量。
