Zhou Cheng-Ming, Cao Jun, Chen Shao-Ke, Tuxun Tuerhongjiang, Apaer Shadike, Wu Jing, Zhao Jin-Ming, Wen Hao
Department of Liver and Laparoscopic Surgery, Digestive and Vascular Surgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China.
Department of Operation Management, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China.
World J Gastrointest Surg. 2024 Jul 27;16(7):2047-2053. doi: 10.4240/wjgs.v16.i7.2047.
The optimal approach for managing hepatic hemangioma is controversial.
To evaluate a clinical grading system for management of hepatic hemangioma based on our 17-year of single institution experience.
A clinical grading system was retrospectively applied to 1171 patients with hepatic hemangioma from January 2002 to December 2018. Patients were classified into four groups based on the clinical grading system and treatment: (1) Observation group with score < 4 (Obs score < 4); (2) Surgical group with score < 4 (Sur score < 4); (3) Observation group with score ≥ 4 (Obs score ≥ 4); and (4) Surgical group with score ≥ 4 (Sur score ≥ 4). The clinico-pathological index and outcomes were evaluated.
There were significantly fewer symptomatic patients in surgical groups (Sur score ≥ 4 Obs score ≥ 4, < 0.001; Sur score < 4 Obs score < 4, ² = 8.60, = 0.004; Sur score ≥ 4 Obs score < 4, < 0.001). The patients in Sur score ≥ 4 had a lower rate of in need for intervention and total patients with adverse event than in Obs score ≥ 4 ( < 0.001; < 0.001). Nevertheless, there was no significant difference in need for intervention and total patients with adverse event between the Sur score < 4 and Obs score < 4 ( > 0.05; ² = 1.68, > 0.05).
This clinical grading system appeared as a practical tool for hepatic hemangioma. Surgery can be suggested for patients with a score ≥ 4. For those with < 4, follow-up should be proposed.
肝血管瘤的最佳治疗方法存在争议。
基于我们17年单中心经验，评估一种用于肝血管瘤治疗的临床分级系统。
回顾性地将一种临床分级系统应用于2002年1月至2018年12月期间的1171例肝血管瘤患者。根据临床分级系统和治疗方法将患者分为四组：（1）评分<4的观察组（观察评分<4）；（2）评分<4的手术组（手术评分<4）；（3）评分≥4的观察组（观察评分≥4）；（4）评分≥4的手术组（手术评分≥4）。评估临床病理指标和结果。
手术组（手术评分≥4与观察评分≥4，P<0.001；手术评分<4与观察评分<4，χ²=8.60，P=0.004；手术评分≥4与观察评分<4，P<0.001）中出现症状的患者明显较少。手术评分≥4的患者与观察评分≥4的患者相比，需要干预的比例和发生不良事件的总患者数更低（P<0.001；P<0.001）。然而，手术评分<4和观察评分<4的患者在需要干预方面以及发生不良事件的总患者数方面没有显著差异（P>0.05；χ²=1.68，P>0.05）。
这种临床分级系统似乎是一种用于肝血管瘤的实用工具。对于评分≥４的患者可建议手术治疗。对于评分<4的患者，应建议进行随访。
