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Feasibility of laparoscopic liver resection for giant hemangioma of greater than 6 cm in diameter.

Kim IS, Kwon CH - Korean J Hepatobiliary Pancreat Surg (2014)

Bottom Line: Liver hemangioma, the most common benign liver tumor, can be safely managed by clinical observation.The median estimated blood loss was 400 ml (range, 50-900).There was no postoperative morbidity, including Clanvien-Dindo grade I.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT

Backgrounds/aims: Liver hemangioma, the most common benign liver tumor, can be safely managed by clinical observation. However, surgical treatment should be considered in a subset of patients with giant hemangioma with abdominal symptoms. We reviewed the feasibility of total laparoscopic liver resection for giant hemangioma of >6 cm in diameter.

Methods: Nine consecutive patients who underwent total laparoscopic liver resection for giant hemangioma between August 2008 to December 2012 were included in this study. Medical records were retrospectively reviewed for demographic data, laboratory findings, and perioperative results.

Results: The median age of patients was 36 yrs (range, 31-63). Eight females and 1 male were included in the study. The median size of hemangioma was 11 cm in diameter (range, 6-18) and 5 patients had a hemangioma >10 cm. Indications for surgical treatments were abdominal symptoms in 4 patients, increased size in 5 patients, and uncertain diagnosis in 1 patient. The median operation time was 522 minutes for right hepatectomy, 220 minutes for left lateral sectionectomy, and 90 minutes for wedge resection. The median estimated blood loss was 400 ml (range, 50-900). There was no postoperative morbidity, including Clanvien-Dindo grade I.

Conclusions: The resection of giant hemangioma demands meticulous surgical technique due to high vascularity and the concomitant risk of intraoperative hemorrhage. Laparoscopic liver resection is feasible with minimal operative complication. Therefore, laparoscopic liver resection can be considered as an option for surgical treatment for giant hemangioma.

No MeSH data available.


Related in: MedlinePlus

Postoperative wound status of patient abdomen.
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Figure 1: Postoperative wound status of patient abdomen.

Mentions: Laparoscopic right hepatectomy was performed in 4 patients. Four patients received left lateral sectionectomy. One patient underwent wedge resection. The median operation time was 522 minutes (range, 422 to 605 minutes) for right hepatectomy, 220 minutes (range, 144 to 271 minutes) for left lateral sectionectomy, and 90 minutes for wedge resection. The operative and postoperative results were described in Table 2. The median estimated blood loss was 400 ml (range, 50 to 900 ml). No patient required blood transfusion. Incision type for specimen retrieval was individually determined based on the previous operation scar and hemangioma size. Pfannenstiel incision, umbilical camera port incision extension, and previous cesarean-section incision were performed on 4, 3, and 2 patients, respectively (Fig. 1). Decompression of hemangiomas during retrieval was performed to decrease the size of incision (Fig. 2). The last 2 cases were performed with decompression. An incision of 8 cm was made on a 13 cm sized giant hemangioma. The incision size was 10 cm for an 18 cm hemangioma. There was no postoperative complication or perioperative mortality, including a Clavien-Dindo classification of surgical complication grade I. The median hospitalization duration was 11 days (range, 6-18 days). There was no correlation between hospitalization duration and the type of operation.


Feasibility of laparoscopic liver resection for giant hemangioma of greater than 6 cm in diameter.

Kim IS, Kwon CH - Korean J Hepatobiliary Pancreat Surg (2014)

Postoperative wound status of patient abdomen.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4492351&req=5

Figure 1: Postoperative wound status of patient abdomen.
Mentions: Laparoscopic right hepatectomy was performed in 4 patients. Four patients received left lateral sectionectomy. One patient underwent wedge resection. The median operation time was 522 minutes (range, 422 to 605 minutes) for right hepatectomy, 220 minutes (range, 144 to 271 minutes) for left lateral sectionectomy, and 90 minutes for wedge resection. The operative and postoperative results were described in Table 2. The median estimated blood loss was 400 ml (range, 50 to 900 ml). No patient required blood transfusion. Incision type for specimen retrieval was individually determined based on the previous operation scar and hemangioma size. Pfannenstiel incision, umbilical camera port incision extension, and previous cesarean-section incision were performed on 4, 3, and 2 patients, respectively (Fig. 1). Decompression of hemangiomas during retrieval was performed to decrease the size of incision (Fig. 2). The last 2 cases were performed with decompression. An incision of 8 cm was made on a 13 cm sized giant hemangioma. The incision size was 10 cm for an 18 cm hemangioma. There was no postoperative complication or perioperative mortality, including a Clavien-Dindo classification of surgical complication grade I. The median hospitalization duration was 11 days (range, 6-18 days). There was no correlation between hospitalization duration and the type of operation.

Bottom Line: Liver hemangioma, the most common benign liver tumor, can be safely managed by clinical observation.The median estimated blood loss was 400 ml (range, 50-900).There was no postoperative morbidity, including Clanvien-Dindo grade I.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

ABSTRACT

Backgrounds/aims: Liver hemangioma, the most common benign liver tumor, can be safely managed by clinical observation. However, surgical treatment should be considered in a subset of patients with giant hemangioma with abdominal symptoms. We reviewed the feasibility of total laparoscopic liver resection for giant hemangioma of >6 cm in diameter.

Methods: Nine consecutive patients who underwent total laparoscopic liver resection for giant hemangioma between August 2008 to December 2012 were included in this study. Medical records were retrospectively reviewed for demographic data, laboratory findings, and perioperative results.

Results: The median age of patients was 36 yrs (range, 31-63). Eight females and 1 male were included in the study. The median size of hemangioma was 11 cm in diameter (range, 6-18) and 5 patients had a hemangioma >10 cm. Indications for surgical treatments were abdominal symptoms in 4 patients, increased size in 5 patients, and uncertain diagnosis in 1 patient. The median operation time was 522 minutes for right hepatectomy, 220 minutes for left lateral sectionectomy, and 90 minutes for wedge resection. The median estimated blood loss was 400 ml (range, 50-900). There was no postoperative morbidity, including Clanvien-Dindo grade I.

Conclusions: The resection of giant hemangioma demands meticulous surgical technique due to high vascularity and the concomitant risk of intraoperative hemorrhage. Laparoscopic liver resection is feasible with minimal operative complication. Therefore, laparoscopic liver resection can be considered as an option for surgical treatment for giant hemangioma.

No MeSH data available.


Related in: MedlinePlus