Greif F, Zifroni A, Madhala O G, Cohen M, Lelcuk S
Dept. of Surgery B, Rabin Medical Center (Beilinson Campus).
Harefuah. 1996 Dec 1;131(11):471-4, 536, 535.
Hemangioma, the most common benign tumor of the liver, is found in 2% of all autopsies. Giant cavernous hemangiomas are those larger than 4 cm, and the only ones of clinical importance. During 1991-95 we saw 69 patients with cavernous hemangiomas of the liver ranging from 2 to 25 cm in diameter. In 62% (30 women and 13 men) they ranged from 4 to 15 cm (mean 6.3). Only 11 patients, in whom the hemangioma was symptomatic, were referred for surgery. The others were either asymptomatic or their symptoms were considered mild, and they were only followed. 4 refused surgery, but in 7 the hemangioma (ranging from 4.8 to 15.0 cm, mean 10.2) was removed; 1 required 4 units of blood. There was no mortality; complications consisted of single cases of slipped tie requiring reoperation for intraabdominal bleeding, a bile leak treated by percutaneous drainage, and delayed wound healing. After 6 months all patients were symptom-free. Our data are consistent with the present trend to operate only when a giant, cavernous hemangioma of the liver produces symptoms.
肝血管瘤是肝脏最常见的良性肿瘤，在所有尸检中占2%。巨大海绵状血管瘤是指直径大于4厘米的血管瘤，也是唯一具有临床重要性的血管瘤。在1991年至1995年期间，我们诊治了69例肝海绵状血管瘤患者，直径从2厘米至25厘米不等。其中62%（30名女性和13名男性）的血管瘤直径在4厘米至15厘米之间（平均6.3厘米）。只有11例有症状的血管瘤患者接受了手术治疗。其他患者要么无症状，要么症状被认为较轻，仅接受随访观察。4例拒绝手术，但7例（血管瘤直径从4.8厘米至15.0厘米，平均10.2厘米）接受了手术切除；1例术中需要输注4单位血液。无死亡病例；并发症包括1例结扎线滑脱导致腹腔内出血需再次手术、1例胆汁漏经皮引流治疗以及伤口愈合延迟。6个月后，所有患者均无症状。我们的数据与目前仅在巨大肝海绵状血管瘤出现症状时才进行手术的趋势一致。
