Yuhui Liu1, Xuyong Wei1, Kun Wang1, Qiaonan Shan1, Haojiang Dai1, Haiyang Xie2, Lin Zhou2, Xiao Xu1,2, Shusen Zheng1,2. 1. Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China. 2. Key Laboratory of Combined Multi-Organ Transplantation, Ministry of Public Health, Hangzhou, China.
Abstract
BACKGROUND: Hepatic hemangiomas are the most common benign liver tumors, and the management of giant hepatic hemangioma (GHH) is still in controversial. The aim of this meta-analysis was to compare the postoperative outcomes of enucleation versus anatomic resection for GHH. METHODS: PubMed, Embase, Web of Science, and the Cochrane Library were searched from January 1988 to December 2015 to identify studies comparing the outcomes of enucleation versus anatomic resection for GHH. Finally, we performed this meta-analysis using the Review Manager 5.3 software, and the results were presented as risk ratio (RR) or mean difference (MD) with corresponding 95% confidence interval (CI). The major limitation is that all data were derived from nonrandomized studies, and we cannot exclude potential selection bias. RESULTS: Nine studies involving 1,185 patients were included. The results showed that there was a lower incidence of complications (RR = 0.66, 95% CI 0.52 to 0.84, I2 = 0%, p = 0.0007); no incidents of death occurred among the 9 included trials. Blood loss (MD = -419.07 mL, 95% CI -575.04 to -263.09, I2 = 83%, p < 0.00001), duration of surgery (MD = -23.5 min, 95% CI -45.28 to -1.74, I2 = 0%, p = 0.03), and length of hospital stay (MD = -1.59 days, 95% CI -3.06 to -0.13, I2 = 0%, p = 0.03) were much lower in the enucleation group. CONCLUSIONS: GHH can be removed safely by either enucleation or anatomic resection. Enucleation can preserve more hepatic parenchyma and reduce postoperative complications, which is why it should be the preferred surgical procedure for suitable lesions.
BACKGROUND:Hepatic hemangiomas are the most common benign liver tumors, and the management of giant hepatic hemangioma (GHH) is still in controversial. The aim of this meta-analysis was to compare the postoperative outcomes of enucleation versus anatomic resection for GHH. METHODS: PubMed, Embase, Web of Science, and the Cochrane Library were searched from January 1988 to December 2015 to identify studies comparing the outcomes of enucleation versus anatomic resection for GHH. Finally, we performed this meta-analysis using the Review Manager 5.3 software, and the results were presented as risk ratio (RR) or mean difference (MD) with corresponding 95% confidence interval (CI). The major limitation is that all data were derived from nonrandomized studies, and we cannot exclude potential selection bias. RESULTS: Nine studies involving 1,185 patients were included. The results showed that there was a lower incidence of complications (RR = 0.66, 95% CI 0.52 to 0.84, I2 = 0%, p = 0.0007); no incidents of death occurred among the 9 included trials. Blood loss (MD = -419.07 mL, 95% CI -575.04 to -263.09, I2 = 83%, p < 0.00001), duration of surgery (MD = -23.5 min, 95% CI -45.28 to -1.74, I2 = 0%, p = 0.03), and length of hospital stay (MD = -1.59 days, 95% CI -3.06 to -0.13, I2 = 0%, p = 0.03) were much lower in the enucleation group. CONCLUSIONS: GHH can be removed safely by either enucleation or anatomic resection. Enucleation can preserve more hepatic parenchyma and reduce postoperative complications, which is why it should be the preferred surgical procedure for suitable lesions.
Authors: Thomas Schnelldorfer; Adam L Ware; Rory Smoot; Cathy D Schleck; William S Harmsen; David M Nagorney Journal: J Am Coll Surg Date: 2010-10-25 Impact factor: 6.113
Authors: Waad Farhat; Houssem Ammar; Mohamed Amine Said; Abdelkader Mizouni; Linda Ghabry; Eya Hammami; Rahul Gupta; Mohamed Ben Mabrouk; Ali Ben Ali Journal: Ann Med Surg (Lond) Date: 2021-07-06