Belle V van Rosmalen1, Jan Jaap de Graeff2, Marcel J van der Poel2, Ilja E de Man2, Marc Besselink2, Mohammad Abu Hilal3, Olivier R Busch2, Joanne Verheij4, Thomas M van Gulik2. 1. Department of Surgery, Cancer Centre Amsterdam, Amsterdam UMC, University of Amsterdam, the Netherlands. Electronic address: b.v.vanrosmalen@amc.uva.nl. 2. Department of Surgery, Cancer Centre Amsterdam, Amsterdam UMC, University of Amsterdam, the Netherlands. 3. Hepatobiliary and Pancreatic Surgical Unit, Department of Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK. 4. Department of Pathology, Cancer Centre Amsterdam, Amsterdam UMC, University of Amsterdam, the Netherlands.
Abstract
BACKGROUND: The value of open and minimally invasive liver resection for symptomatic solid benign liver tumours (BLT) such as hepatocellular adenoma, focal nodular hyperplasia and haemangioma is being debated. A systematic review on symptom relief, quality of life (QoL) and surgical outcome after both open and minimally invasive surgery for solid BLT is currently lacking. METHODS: A systematic search in PubMed and EMBASE was performed according to the PRISMA guidelines (January 1985-April 2018). Articles reporting pre-and postoperative symptoms or QoL in patients undergoing open or minimally surgery for BLT were evaluated. Methodological quality was assessed using the MINORS tool. RESULTS: Forty-two studies were included with 4061 patients undergoing surgery for BLT, 3536 (87%) open and 525 (13%) laparoscopic resections. Randomized and propensity-matched studies were lacking. Symptoms were the indication for resection in 56% of the patients. After a weighted mean of 28.5 months follow-up after surgery, symptoms were relieved in 82% of symptomatic patients. Validated QoL tools were used in eight studies, of which two found significant better QoL scores following laparoscopic compared to open surgery. DISCUSSION: Resection of symptomatic BLT seems safe and relieves symptoms in the vast majority of selected patients. Comparative studies are needed before more firm conclusions can be drawn.
BACKGROUND: The value of open and minimally invasive liver resection for symptomatic solid benign liver tumours (BLT) such as hepatocellular adenoma, focal nodular hyperplasia and haemangioma is being debated. A systematic review on symptom relief, quality of life (QoL) and surgical outcome after both open and minimally invasive surgery for solid BLT is currently lacking. METHODS: A systematic search in PubMed and EMBASE was performed according to the PRISMA guidelines (January 1985-April 2018). Articles reporting pre-and postoperative symptoms or QoL in patients undergoing open or minimally surgery for BLT were evaluated. Methodological quality was assessed using the MINORS tool. RESULTS: Forty-two studies were included with 4061 patients undergoing surgery for BLT, 3536 (87%) open and 525 (13%) laparoscopic resections. Randomized and propensity-matched studies were lacking. Symptoms were the indication for resection in 56% of the patients. After a weighted mean of 28.5 months follow-up after surgery, symptoms were relieved in 82% of symptomatic patients. Validated QoL tools were used in eight studies, of which two found significant better QoL scores following laparoscopic compared to open surgery. DISCUSSION: Resection of symptomatic BLT seems safe and relieves symptoms in the vast majority of selected patients. Comparative studies are needed before more firm conclusions can be drawn.
Authors: B V van Rosmalen; A J Klompenhouwer; J Jaap de Graeff; M P D Haring; V E de Meijer; L Rifai; S Dokmak; A Rawashdeh; M Abu Hilal; M C de Jong; C H C Dejong; M Doukas; R A de Man; J N M IJzermans; O M van Delden; J Verheij; T M van Gulik Journal: Br J Surg Date: 2019-07-17 Impact factor: 6.939