Department of General Surgery, Shengjing Hospital of China Medical University, No.36 Sanhao Street, Heping District, Shenyang, 110004, Liaoning, China.
BMC Surg. 2020 Nov 7;20(1):271. doi: 10.1186/s12893-020-00935-0.
Liver resection (LR) and enucleation (EN) are the main surgical treatment for giant hepatic hemangioma (HH), but how to choose the type of surgery is still controversial. This study aimed to explore the efficacy and the factors affecting the choice of open procedure for HH.
The data for patients with pathologically confirmed HH who underwent open surgery from April 2014 to August 2020 were analyzed retrospectively. Univariate and multivariate analyses with logistic regression were performed to disclose the factors associated with the choice of EN or LR. Propensity score matching (PSM) analysis was used to compare the efficacy of the two procedures.
A total of 163 and 110 patients were enrolled in the EN and LR groups. Following 1:1 matching by PSM analysis, 66 patients were selected from each group. Centrally located lesions (OR: 0.131, 95% CI 0.070-0.244), tumors size > 12.1 cm (OR: 0.226, 95% CI 0.116-0.439) and multiple tumors (OR: 1.860, 95% CI 1.003-3.449) were independent factors affecting the choice of EN. There was no significant difference in the median operation time (156 vs. 195 min, P = 0.156), median blood loss (200 vs. 220 ml, P = 0.423), blood transfusion rate (33.3% vs. 33.3%, P = 1.000), mean postoperative feeding (3.1 vs. 3.3 d, P = 0.460), mean postoperative hospital stay (9.5 vs. 9.0 d, P = 0.206), or the major complication rates between the two groups.
Peripherally located lesions, tumors size ≤ 12.1 cm and multiple tumors were more inclined to receive EN. There was no significant difference in the efficacy of EN or LR.
肝切除术（LR）和肝切除术（EN）是治疗巨大肝血管瘤（HH）的主要手术治疗方法，但如何选择手术类型仍存在争议。本研究旨在探讨开放式手术治疗 HH 的疗效及影响手术方式选择的因素。
回顾性分析 2014 年 4 月至 2020 年 8 月期间接受开放性手术的经病理证实的 HH 患者的数据。采用单因素和多因素逻辑回归分析，揭示与 EN 或 LR 选择相关的因素。采用倾向评分匹配（PSM）分析比较两种手术的疗效。
共纳入 163 例和 110 例患者分别纳入 EN 和 LR 组。经 1：1PSM 分析后，每组各有 66 例患者入选。中央位置病变（OR：0.131，95%CI 0.070-0.244）、肿瘤直径>12.1cm（OR：0.226，95%CI 0.116-0.439）和多发病灶（OR：1.860，95%CI 1.003-3.449）是影响 EN 选择的独立因素。两组患者的中位手术时间（156 分钟比 195 分钟，P=0.156）、中位出血量（200ml 比 220ml，P=0.423）、输血率（33.3%比 33.3%，P=1.000）、平均术后进食时间（3.1 天比 3.3 天，P=0.460）、平均术后住院时间（9.5 天比 9.0 天，P=0.206）或主要并发症发生率均无显著差异。
周围位置病变、肿瘤直径≤12.1cm 和多发病灶更倾向于接受 EN。EN 或 LR 的疗效无显著差异。
