Giant Haemangioma of the Liver: Is Enucleation Better than Resection?

Singh, Rajneesh Kumar; Kapoor, Sorabh; Sahni, Peush; Tk, Chattopadhyay

doi:10.1308/003588407x202038

Cited by 59 publications

(50 citation statements)

References 18 publications

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“…Finally, 7 studies involving 913 patients were included in the meta-analysis. [9][10][11][12][13][14][15] All included studies were non-randomised controlled trials. Three were from the United States, one was from Turkey, one from India, one from Italy and one from China.…”

Section: Resultsmentioning

confidence: 99%

Enucleation versus hepatectomy for giant hepatic haemangiomas: a meta-analysis

Cheng

Wang

et al. 2017

annals

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INTRODUCTION Hepatic haemangiomas are the most common benign liver tumours. They can be treated with surgical resection such as enucleation or hepatectomy if necessary. However, controversy remains over the clinical outcome and safety of these two methods. In this study, we performed a comprehensive meta-analysis to compare the efficacy of liver resection with enucleation for giant haemangiomas. METHODS The online databases PubMed, Embase and CNKI (China National Knowledge Infrastructure) were searched for relevant original articles. We compared operation time, blood loss, transfusion requirements, inflow occlusion time and postoperative complications between enucleation and hepatectomy. RESULTS Seven controlled clinical trials met the predefined inclusion criteria. Analysis indicated that the enucleation group had significantly shorter operation time (weighted mean difference, WMD -28.22, 95% confidence interval, CI, -54.82 to -1.62), less blood loss (WMD -395.92, 95% CI -521.25 to -270.58) and fewer complications (odds ratio, OR, 0.47, 95 % CI 0.34 to 0.65). There were no significant differences between enucleation and hepatectomy with regard to transfusion requirements (OR 0.61, 95% CI 0.22 to 1.68) and inflow occlusion time (WMD 7.91, 95% CI -5.62 to 21.44). CONCLUSIONS Enucleation has advantages over hepatectomy in relation to operation time, blood loss and complications. Enucleation is a safe and effective treatment for giant hepatic haemangioma.

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Section: Resultsmentioning

confidence: 99%

Enucleation versus hepatectomy for giant hepatic haemangiomas: a meta-analysis

Cheng

Wang

et al. 2017

annals

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“…Two common procedures for surgical intervention include enucleation and resection. Until recently, authors reported that enucleation was associated with decreased morbidity, intraoperative bleeding, hospital stay, and operative times [29][30][31][32]. Nevertheless, these studies included few patients with hemangiomas >10cm.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Trans-Arterial Embolization and Surgical Resection for Giant Liver Hemangioma: A Multidisciplinary Approach

Tieniber¹,

Shah²,

Eng³

et al. 2017

JGPLD

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A 47-year-old male presenting with abdominal distension and pain was found to have a giant hemangioma of the liver measuring 22cm in its greatest diameter upon preoperative MRI. The patient underwent preoperative trans-arterial embolization (TAE) of the hemangioma, followed by extended right hepatectomy for definitive treatment. This case illustrates a novel multidisciplinary approach to the treatment of a massive liver hemangioma. We propose a new classification of these > 20 cm hemangiomas that require preoperative TAE as "Super Hemangiomas."

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“…Enucleation was first described in 1988 [24], and since then, many researchers have reported their experiences with this technique [22,[25][26][27][28]. Many institutions reported that enucleation can be performed safely, even with total vascular occlusion, when the hemangioma is very large or at a dangerous anatomical location adjacent to the inferior vena cava or a major hepatic vein.…”

Section: Discussionmentioning

confidence: 99%

Enucleation is Better for a Giant Hemangioma Proximal to the Hepatic Portal Vascular Structures

Bao

Zhu

2015

Indian J Surg

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The aim of this study is to compare the effect of liver enucleation with resection of a giant hemangioma proximal to the hepatic portal vascular structures. From 2008 to 2014, 53 patients with giant hemangiomas proximal to the hepatic portal vascular structures underwent surgery in our hospital by the same surgical team. The indications for surgery included a tumor size greater than 8 cm, a middle size greater than 4 cm but with abdominal pain, a rapidly increased tumor size with uncertain malignancy, or tumor rupture. Thirty-two patients (60 %) had pain only, 15 (29 %) had pain with tumor growth, 5 patients (9 %) had an uncertain diagnosis, and 1 patient (2 %) had tumor rupture. Enucleation was performed in 31 patients and liver resection was performed in 22 patients. There were no significant differences in the size of the hemangioma (13.9±3.1 vs 12.3±5.5 cm; P>0.05), preoperative liver function tests, hemoglobin levels, and platelet counts between the enucleation and resection groups. The mean intraoperative blood loss was significantly less in the enucleation group compared with the resection group (350.9±89.8 vs 988±91.7 mL; P<0.01), and the enucleation group had a significantly shorter mean operative time (1.7±0.4 vs 2.9± 0.9 h; P<0.01) and significantly shorter duration of hospital stay (9.6±4.2 vs 14.7±3.7 days; P<0.05). Five patients in the resection group and only 1 patient in the enucleation group had major postoperative complications. Compared to liver resection, enucleation is safer and faster for liver hemangiomas proximal to the hepatic portal vascular structures and is associated with fewer complications.

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Giant Haemangioma of the Liver: Is Enucleation Better than Resection?

Cited by 59 publications

References 18 publications

Enucleation versus hepatectomy for giant hepatic haemangiomas: a meta-analysis

Enucleation versus hepatectomy for giant hepatic haemangiomas: a meta-analysis

Preoperative Trans-Arterial Embolization and Surgical Resection for Giant Liver Hemangioma: A Multidisciplinary Approach

Enucleation is Better for a Giant Hemangioma Proximal to the Hepatic Portal Vascular Structures

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