Long-term results of surgery for liver hemangiomas.
BACKGROUND
Elective surgery for liver hemangiomas is still controversial.


OBJECTIVE
Long-term results show that elective surgery for liver hemangiomas is safe and effective.


METHODS
A tertiary care university hospital in Istanbul, Turkey.


METHODS
Forty-two patients underwent surgery for liver hemangiomas between January 1988 and December 1998; 41 were symptomatic. The primary indications for surgery were abdominal pain in 33 patients, diagnostic uncertainty in 6, and enlargement in 3. The median largest dimension of the major lesion was 10 cm (range, 7-45 cm).


METHODS
(1) Patients' assessment of the effects of surgery on preoperative symptoms, (2) determination of whether any other pathological conditions were missed in the preoperative evaluation, (3) operative mortality and morbidity, and (4) recurrences.


METHODS
Retrospective cohort study.


RESULTS
Enucleation was the most frequent operation (33 patients). Hospital mortality and morbidity were 2.4% (bleeding from the biopsy site on a lesion evaluated as inoperable at laparotomy; 1 patient) and 12% (5 patients), respectively. Thirty-three patients could be followed up for a median of 53 months (range, 6-135 months). Of the 32 preoperatively symptomatic patients, surgery was successful in symptom control in 28 (88%) (complete resolution or significant amelioration). No other cause of pain could be identified during follow-up in the other patients. Control ultrasonography revealed no recurrences.


CONCLUSIONS
Elective surgery is indicated in a small subset of patients with hemangiomas because of abdominal pain, enlargement, and diagnostic uncertainty. The results of surgery in symptom control are gratifying in approximately 90% of patients. Recurrences are rare. Enucleation can be performed rapidly and safely in most patients and should be preferred to resection.
Ataköy 9. Kisim, A2B Blok D 123, Istanbul 34750, Turkey. hpbcer@superonline.com.
I
I
Ozden
A
A
Emre
A
A
Alper
M
M
Tunaci
K
K
Acarli
O
O
Bilge
Y
Y
Tekant
O
O
Ariogul
D015746:Abdominal Pain / Q000503:physiopathology; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D017558:Elective Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006391:Hemangioma / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D006529:Hepatomegaly / Q000503:physiopathology; D006801:Humans; D007431:Intraoperative Complications; D008113:Liver Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D017060:Patient Satisfaction; D011183:Postoperative Complications; D019106:Postoperative Hemorrhage / Q000209:etiology; D012189:Retrospective Studies; D012449:Safety; D015996:Survival Rate; D016896:Treatment Outcome