title: Management of the focal nodular hyperplasia of the liver: evaluation of the surgical treatment comparing with observation only.
abstract: BACKGROUND
  Long-term results of both surgery and observation for patients with focal nodular hyperplasia (FNH) in a large single-center experience do not exist. Accordingly, the aim of this study was to compare long-term outcomes in patients with FNH who underwent either elective hepatectomy or observation alone.
  
  
  METHODS
  A retrospective single-institution analysis of 185 patients with FNH, treated from 1990 to 2009, was performed.
  
  
  RESULTS
  Seventy-eight patients underwent elective hepatectomy and 107 patients observation alone, with a median follow-up period of 113 months. There was no perioperative mortality. Postoperative complications were recorded in 12 patients, and 92% of patients reported symptomatic reductions. Among observation patients, 9 (13%) developed additional symptoms; tumor enlargement was seen in 3 patients (4%).
  
  
  CONCLUSIONS
  Elective liver resection for FNH is a safe procedure at high-volume centers. This single-center experience showed that 13% of observed patients had protracted symptoms. This justifies the therapeutic algorithm that elective surgery should be considered in symptomatic patients or in those with marked enlargement.
authors.affiliation: Department of Surgery, University of Erlangen-Nuremberg, Erlangen, Germany. aristotelis.perrakis@uk-erlangen.de
authors.forename: Aristotelis
authors.initials: A
authors.lastname: Perrakis
authors.forename: Resit
authors.initials: R
authors.lastname: Demir
authors.forename: Volker
authors.initials: V
authors.lastname: Müller
authors.forename: Jürgen
authors.initials: J
authors.lastname: Mulsow
authors.forename: Ünal
authors.initials: Ü
authors.lastname: Aydin
authors.forename: Sedat
authors.initials: S
authors.lastname: Alibek
authors.forename: Werner
authors.initials: W
authors.lastname: Hohenberger
authors.forename: Süleyman
authors.initials: S
authors.lastname: Yedibela
mesh_terms: D000328:Adult; D000465:Algorithms; D003661:Decision Support Techniques; D017558:Elective Surgical Procedures; D005260:Female; D020518:Focal Nodular Hyperplasia / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D057832:Watchful Waiting