Jiang Bin, Shen Zheng-Chao, Fang Xiao-San, Wang Xiao-Ming
Department of Hepato-Biliary-Pancreatic Surgery, The First Affiliated Hospital of Wannan Medical College (Yijishan Hospital), Wuhu, China.
Front Surg. 2022 Jul 28;9:960768. doi: 10.3389/fsurg.2022.960768. eCollection 2022.
To compare the safety and efficacy of enucleation and hepatectomy for the treatment of hepatic hemangioma (HH).
A systematic literature search was conducted to identify studies evaluating enucleation versus hepatectomy for HH starting from the time of database creation to February 2022. Extraction of the data used in this study was done from the literature. The differences between the two surgical approaches were evaluated by comparing and analyzing the relevant data by means of meta-analysis.
A total of 1,384 patients (726 underwent enucleation, and 658 with hepatectomy) were included in our meta-analysis from 12 studies. Enucleations were associated with favorable outcomes in terms of operation time [mean difference (MD): -39.76, 95% confidence interval (CI): -46.23, -33.30], blood loss (MD: -300.42, 95% CI: -385.64, -215.19), length of hospital stay (MD: -2.33, 95% CI: -3.22, -1.44), and postoperative complications (OR: 0.57, 95% CI: 0.44-0.74). There were no differences between the groups in terms of patients needing transfusion (OR: 0.85, 95% CI: 0.50, 1.42), inflow occlusion time (MD: 1.72, 95% CI: -0.27, 3.71), and 30-day postoperative mortality (OR: 0.23, 95% CI: 0.02-2.17).
Compared with hepatectomy, enucleation is found to be effective at reducing postoperative complications, blood loss, and operation time and shortening the length of hospital stay. Enucleation is similar to hepatectomy in terms of inflow occlusion time, 30-day postoperative mortality, and patients needing transfusing to hepatectomy.
比较肝血管瘤(HH)剜除术与肝切除术的安全性和疗效。
进行系统的文献检索,以确定从数据库创建至2022年2月评估HH剜除术与肝切除术的研究。本研究使用的数据从文献中提取。通过荟萃分析比较和分析相关数据,评估两种手术方法之间的差异。
我们的荟萃分析纳入了来自12项研究的1384例患者(726例行剜除术,658例行肝切除术)。在手术时间[平均差(MD):-39.76,95%置信区间(CI):-46.23,-33.30]、失血量(MD:-300.42,95%CI:-385.64,-215.19)、住院时间(MD:-2.33,95%CI:-3.22,-1.44)和术后并发症(OR:0.57,95%CI:0.44 - 0.74)方面,剜除术的结果更优。两组在需要输血的患者(OR:0.85,95%CI:0.50,1.42)、入肝血流阻断时间(MD:1.72,95%CI:-0.27,3.71)和术后30天死亡率(OR:0.23,95%CI:0.02 - 2.17)方面无差异。
与肝切除术相比,发现剜除术在减少术后并发症、失血量和手术时间以及缩短住院时间方面有效。在入肝血流阻断时间、术后30天死亡率以及需要输血的患者方面,剜除术与肝切除术相似。