Hepatic Hemangioma Research Articles

Giant Exophytic Cavernous Hemangioma Of The Liver In A Middle-aged West-african Woman: A Case Report

Background: Hemangiomas are the most common benign liver tumor. While the majority of these lesions remain asymptomatic, the giant ones often produce symptoms that would prompt intervention. Modern imaging studies have made diagnosing most of these lesions pre-operatively possible. However, as our case presentation illustrates, in resource-poor countries with limited availability of modern imaging studies, diagnosis may still be delayed. Case Report: We present a 54-year-old woman who was referred to us on account of a symptomatic abdominal mass that was found, on ultrasound, to be heterogenous in nature and located in the upper abdomen. She was subsequently able to do only an abdominal computed tomography, which was not typical for the diagnosis of hemangioma. She had surgical resection of the liver mass with an uneventful recovery. Her symptoms resolved afterwards, and the mass was confirmed to be a hemangioma histologically. We reviewed the clinical peculiarities of exophytic liver hemangiomas and their radiological features, especially the essential diagnostic features on axial imaging. The various treatment options for symptomatic hemangiomas were explored, including the advantages of enucleation and why our patient could not benefit from it. Conclusion: Liver hemangiomas may require treatment when symptomatic. These lesions can be diagnosed with high-quality radiological imaging and surgically resected if indicated. Where imaging facilities are scarce, thorough patient evaluation and sound surgical decision-making are emphasised

Enucleation versus hepatectomy for hepatic hemangiomas: A meta-analysis.

ObjectiveTo compare the safety and efficacy of enucleation and hepatectomy for the treatment of hepatic hemangioma (HH).MethodsA systematic literature search was conducted to identify studies evaluating enucleation versus hepatectomy for HH starting from the time of database creation to February 2022. Extraction of the data used in this study was done from the literature. The differences between the two surgical approaches were evaluated by comparing and analyzing the relevant data by means of meta-analysis.ResultsA total of 1,384 patients (726 underwent enucleation, and 658 with hepatectomy) were included in our meta-analysis from 12 studies. Enucleations were associated with favorable outcomes in terms of operation time [mean difference (MD): −39.76, 95% confidence interval (CI): −46.23, −33.30], blood loss (MD: −300.42, 95% CI: −385.64, −215.19), length of hospital stay (MD: −2.33, 95% CI: −3.22, −1.44), and postoperative complications (OR: 0.57, 95% CI: 0.44–0.74). There were no differences between the groups in terms of patients needing transfusion (OR: 0.85, 95% CI: 0.50, 1.42), inflow occlusion time (MD: 1.72, 95% CI: −0.27, 3.71), and 30-day postoperative mortality (OR: 0.23, 95% CI: 0.02–2.17).ConclusionCompared with hepatectomy, enucleation is found to be effective at reducing postoperative complications, blood loss, and operation time and shortening the length of hospital stay. Enucleation is similar to hepatectomy in terms of inflow occlusion time, 30-day postoperative mortality, and patients needing transfusing to hepatectomy.

Prevalence and Characteristics of Hepatic Hemangioma Associated with Coagulopathy and Its Predictive Risk Factors.

Background: Knowledge of the relationships between hepatic hemangiomas and coagulopathy and the risk factors for hemangiomas is lacking. The aim of this study was to investigate the prevalence and characteristics of hepatic hemangiomas associated with coagulopathy, elucidate the causes of coagulopathy, and identify the predictive factors for hemangioma-related complications. Methods: In 281 consecutive patients with hepatic hemangiomas, we performed ultrasonography and conducted serum laboratory tests for liver function and six coagulation factors, i.e., platelets, as well as five coagulation fibrinolytic markers (prothrombin time (PT), fibrinogen, thrombin-antithrombin III complex (TAT), d-dimer, and fibrin and fibrinogen degradation products (FDP)) as indicators of coagulation disorder. Results: Among 281 patients, 56 (19.9%) had abnormal coagulation factors. Abnormal values of d-dimer were most frequently found among the six coagulation factors. The number of abnormal coagulation factors was significantly correlated with tumor size, M2BPGi, and HDL cholesterol, among which tumor size was the most significant independent predictor of the number of abnormal coagulation factors. Conclusions: The prevalence of hepatic hemangiomas associated with coagulopathy was relatively high and became more frequent with increases in tumor size. Predictive factors of hemangioma-related complications were found to be a tumor size of >5 cm in diameter and coagulopathy, especially the elevation of d-dimer.

Elevated alpha-fetoprotein in asymptomatic adults: Clinical features, outcome, and association with body composition.

Background and aimApparently healthy individuals with elevated serum alpha-fetoprotein (AFP) levels (>7 ng/mL) for unknown causes visit clinics. We investigated their clinical characteristics, outcomes, and relationship with body fat deposition and muscle mass.MethodsThe case group included asymptomatic 137 individuals with “elevated AFP level” (R772) diagnostic code from 2009 to 2018 in a tertiary hospital. The control group enrolled 274 age- and sex-matched patients with <5 cm hepatic hemangiomas. Hepatic, visceral, and psoas muscle adiposity and psoas muscle index (PMI) were measured in the subgroups of 45 cases and 90 controls with pre-contrast computed tomography (CT) images.ResultsThe case group (mean age 47.5 years, male 35.8%) showed higher AFP levels (10.3 vs 2.5 ng/mL, p<0.001) and total bilirubin (0.8 vs 0.7 mg/dL, p<0.001), but a lower body mass index (22.2 vs 23.3 kg/m2, p = 0.011) and alanine aminotransferase levels (17.0 vs 19.0 IU/L, p = 0.047) than the controls. During 13 months of median follow-up, there was no cancer or liver disease development. The AFP levels were stable. In the subgroups with CT images, cases showed a lower proportion of hepatic steatosis (4.4% vs 18.9%, p = 0.023), higher psoas muscle attenuation (48.2 vs 43.8 Hounsfield units, p<0.001) and higher PMI (5.7 vs 4.2 cm2/m2, p<0.001) than the controls.ConclusionElevated AFP levels in asymptomatic individuals may play a role in expressing a protective phenotype against hepatic steatosis, myosteatosis, and sarcopenia. AFP levels in patients with elevated AFP were stable during follow-up without liver injury or cancer development. Interaction between AFP expression and steatosis warrants further study.

Radiation metothds for the diagnosis of liver hemangiomas

Aim. To determine the value of radiation imaging techniques such as US, CT and MRI for diagnosing liver hemangiomas. Materials and methods. The article presents the results of radiations diagnostics of 96 patients with the hepatics hemangiomas. Patients age ranged from 16 to 73 years (mean age 42 ± 10 years). There was a significant predominance of women 78 (83.1 %). And the ratio of women to men was 4.8 : 1. The tumor occupied the area of one segment of the liver in 21 (21.8 %) cases, two segments in 35 (35.4 %), three segments - in 17 (17.7 %), four or more segments - in 23 (23.9 %) cases. Results. Non-invasive diagnostic methods are very effective and allow timely detect of liver hemangiomas in most patients. According to the material, the informativeness of radiation diagnostic methods was at least 90 %. Conclusion. MRI, in comparison to CT and ultrasound, is considered a more sensitive and informative method. But taking into account the prevalence, safety and affordability, it is necessary to give preference to ultrasound diagnostics as the primary link in radiation imaging.

Computed Tomography Fluoroscopy–Guided Percutaneous Transhepatic Bleomycin/Ethiodized Oil Sclerotherapy for Symptomatic Giant Hepatic Hemangioma

PurposeTo determine the safety and efficacy of computed tomography (CT) fluoroscopy–guided percutaneous transhepatic sclerotherapy with a bleomycin/ethiodized oil emulsion for symptomatic giant hepatic hemangiomas. Materials and MethodsThe procedure was performed on 22 patients with symptomatic giant hepatic hemangiomas in an outpatient setting between 2018 and 2020. All patients were followed clinically and underwent contrast-enhanced magnetic resonance imaging after 1 month and again at a mean time of 15 months ± 2. Adverse events were classified according to the Common Terminology Criteria for Adverse Events (CTCAE, v5.0), in which a severe adverse event was defined as an adverse event with a grade of ≥3. The desired radiologic response (volume and index size) and improvement of pain intensity (visual analog scale [VAS]) and other symptoms were recorded as outcomes. ResultsOverall, patients showed a 36.4% ± 8.6 reduction in volume and a 14% ± 1.6 reduction in index size after 1 month, with P values of .002 and .001, respectively. The final follow-up volume and index size were 194.7 cm3 ± 25.8 and 77 mm ± 36, respectively. Moreover, a 53.0% ± 7 reduction in volume and 22% ± 3.7 reduction in index size during the final imaging were reported, with the P values of .001 and .001, respectively. Significant reductions in the mean pain intensity (90% of patients with lower VAS scores after intervention) and symptoms were reported. Four patients were classified as clinically unsuccessful, and were recommended further procedures for residual pain. ConclusionsCT fluoroscopy–guided transhepatic sclerotherapy is an effective, safe, and minimally invasive method to manage giant hepatic hemangiomas in an outpatient setting.

The surgical outcomes and risk factors of giant hepatic haemangiomas: a single centre experience

ObjectiveTo evaluate the safety of performing surgery on cavernous haemangiomas in the liver larger than 10 cm and establish preoperative predictors of intraoperative blood transfusion and morbidity.MethodsA total of 373 patients with haemangiomas larger than 10 cm who underwent surgery in our hospital were retrospectively analysed. According to tumour diameter, the patients were divided into a giant haemangioma (GH) group (241 cases) (10 cm ≤ diameter < 15 cm) and an enormous haemangioma (EH) group (132 cases) (diameter ≥ 15 cm). Clinical parameters were then compared between the two groups.ResultsCompared with the GH group, the EH group had higher rates of leukopenia (10.6% vs. 4.5%), anaemia (26.5% vs. 15.7%), and thrombocytopenia (13.6% vs. 6.2%). The occlusion time in the EH group was longer than that in the GH group (26.33 ± 14.10 min vs. 31.85 ± 20.09 min, P < 0.01). The blood loss and blood transfusion in the EH group were greater than those in the GH group (P < 0.05). Moreover, the morbidity in the EH group was higher than that in the GH group (17.4% vs. 9.13%, P < 0.05). According to the results of the multivariable analysis, the operation time and size of the haemangioma may be independent risk factors for blood transfusion (P < 0.05). Additionally, the size of the haemangioma may be an independent risk factor associated with complications (P < 0.05).ConclusionEnormous haemangioma is more likely to cause haematologic abnormalities than giant hepatic haemangioma. The risks of the operation and postoperative complications of enormous haemangioma are higher than those of giant hepatic haemangioma.

Empirical Assessment of Ultrasound Model Based Reconstructive Elasticity Imaging

In order to rebuild the spatial distribution of Young's modulus, Elasticity Imaging (EI) employs state-of-the-art imaging technology to quantify the displacement of tissues in response to mechanical stimulation. In this paper, we provide a method for ultrasonic EI that makes use of the Model-Based Reconstruction (MBR) approach to Young's modulus reconstruction. Since the object being imaged has an unusual shape, only the longitudinal element of the strain matrix is employed. The technique is particularly successful in its numerical implementation since it uses an analytic solution to the Elasticity Reconstruction (ER) problem. The categorization of liver hemangiomas and the staging of Deep Venous Thrombosis (DVT) are two potential clinical applications of the model-based approach. In sum, these researches show that model-based prosthetic EI may be useful provided both the item's shape and its neighboring cells are understood, and when specific assertions about the pathologies could be established.

Digital Staging of Hepatic Hemangiomas Reveals Spatial Heterogeneity in Endothelial Cell Composition and Vascular Senescence.

Hepatic hemangioma (HH) is the most common benign primary liver tumor; however, despite its high prevalence, a stage-specific classification of this tumor is currently missing. For a spatial stage-specific classification, a tissue microarray (TMA) consisting of 98 HHs and 80 hemangioma margins and 78 distant liver tissues was digitally analyzed for the expression of 16 functional and vascular niche-specific markers. For cross-correlation of histopathology and functional characteristics, computed tomography/MRI imaging data of 28 patients were analyzed. Functional and morphological analyses revealed a high level of intra- and interpatient heterogeneity, and morphological heterogeneity was observed with regard to cellularity, vascular diameter, and endothelial cell subtype composition. While regressed hemangiomas were characterized by low blood vessel density, low beta-catenin levels, and a microvascular phenotype, non-regressed HHs showed a pronounced cellular and architectural heterogeneity. Functionally, cellular senescence-associated p16 expression identified an HH subgroup with high vascular density and increased lymphatic endothelial cell content. Histological HH regions may be grouped into spatially defined morphological compartments that may reflect the current region-specific disease stage. The stage-specific classification of HHs with signs of regression and vascular senescence may allow a better disease course-based and cell state-based subtyping of these benign vascular lesions.

Comparison of efficacy and safety of laparoscopic and open enucleation for liver hemangioma in the right hemi liver: a retrospective cohort study.

BackgroundOpen enucleation (OE) is often performed for giant liver hemangioma (LH) because of its advantage in maximum preservation of functional liver parenchyma. Laparoscopic enucleation (LE) has been applied to LHs more frequently for its potential advantages in postoperative recovery and blood loss. However, to date, LE is still a difficult and complex surgical technique especially when the hemangioma is located in the right hemi liver. The aim of this study was to analyze whether LE is superior to OE for LH in the right hemi liver.MethodsDemographics and perioperative data of patients who underwent LE or OE for LH in the right hemi liver between May 2013 and July 2020 were collected. To decrease the selection bias, patients who underwent OE in first 2 years and those underwent LE in next 5 years by a same operation team were included. The data of sex, age, body mass index (BMI), American Society of Anesthesiologists (ASA) score, largest tumor size, and removed tumor number were enrolled in the propensity score matching (PSM) method to compensate for differences in the baseline characteristics between LE and OE groups. The perioperative outcomes were compared between 2 matched groups after PSM method.ResultsA total of 110 patients (36 LE vs. 74 OE) were matched by age, sex, BMI, ASA grade score, largest tumor size, removed tumor number and tumor location. Finally, 34 patients in each group were retained after PSM. There were no significant differences in operative time, estimated blood loss, amount of autologous transfusion, morbidity grade and the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) on postoperative day 1 or 3 or 5. LE was associated with a significantly higher rate of use of the Pringle maneuver (P<0.001), shorter time to oral feeding (P<0.001) and shorter postoperative length of stay (P<0.001).ConclusionsFor LHs in the right hemi liver, the perioperative safety of LE is not inferior to OE, and LE seems to achieves a faster recovery from surgery compared with OE.

A rare case report: Giant hepatic cavernous hemangioma

Hepatic cavernous hemangioma is the most common benign tumour of liver. Most of them are small in size and asymptomatic. Giant hepatic hemangiomas are uncommon with rare complications of rupture and haemorrhage. We report here a 41 year old female with asymptomatic giant cavernous hemangioma. Pre-operative findings was suspected on CT scan. Pathological findings of the resected mass were consistent with giant cavernous hemangioma. The patient was discharged post operatively without further complications and the patient condition was found to be improved during follow up.

Differentiation of hepatic alveolar echinococcosis with a hemangioma-like pattern compared to typical liver hemangioma using contrast-enhanced ultrasound: a pilot study

PurposeEchinococcus multilocularis infects humans as a false intermediate host, primarily with intrahepatic manifestation. Incorrect diagnostic interpretation of these liver tumors, especially the hemangioma-like pattern, can lead to progressive disease. The aim of the study was to investigate the differentiation of typical hemangioma and a hemangioma-like pattern of E. multilocularis using contrast-enhanced ultrasound (CEUS).MethodsThis prospective clinical pilot study comprised patients with hemangioma (n = 14) and patients with alveolar echinococcosis (AE) and hemangioma-like pattern (n = 7). Inclusion criteria were the detection of a liver lesion according to a hemangioma-like pattern on E. multilocularis Ulm classification—ultrasound (EMUC-US) and “confirmed” or “probable” AE according to WHO case definition. The comparison group had hepatic hemangioma with typical B-scan sonographic morphology. All participants underwent conventional and contrast-enhanced ultrasonography.ResultsThe patient group comprised five men (71.4%) and two women (28.6%) with a mean average age of 64.1 ± 11.2 years. The patient group with hemangioma comprised nine female subjects (64.3%) and five male subjects (35.7%) with a mean average age of 56.1 ± 12.0 years. Early arterial bulbous ring enhancement (p < 0.0001) and iris diaphragm phenomenon could only be visualized in the patients with hemangioma (p < 0.0001). Furthermore, the patients with hemangioma exhibited hyperenhancement in the late phase (p = 0.0003). In contrast, the patients exhibited typical early arterial rim enhancement (p < 0.0001) and, in the portal venous and late phase, complete or incomplete non-enhancement (black hole sign; p = 0.0004).ConslusionThe behavior of hemangioma-like AE lesions and typical liver hemangiomas is significantly different on CEUS. AE should be considered as a possible differential diagnosis, especially in high-endemic areas.

The simultaneous appearance of Kasabach-Merritt syndrome and focal nodular hyperplasia: a rare case with literature review

Introduction and importance: The simultaneous development of Kasabach-Merritt syndrome (KMS) and focal nodular hyperplasia (FNH) in the same individual is rare. This study aims to report the coexistence of KMS and FNH in a 32-year-old female. Case presentation: A 32-year-old woman presented to the gastroenterology clinic complaining of heavy menses, fatigue, and hematuria. Physical examination revealed multiple ecchymoses on the skin. Abdominal computed tomography scan revealed a large hepatic lesion with features of atypical hemangioma. Complete blood count showed normochromic, normocytic red blood cells, and thrombocytopenia. Surgery was decided based on a clinical diagnosis of KMS resulting from a giant liver hemangioma. Histopathologic diagnosis of the resected lesion was FNH. Clinical discussion: KMS, which refers to a giant hemangioma associated with thrombocytopenia, was initially described by Kasabach and Merritt. It occurs in nearly 1% of hemangiomas and primarily affects infants. KMS is a life-threatening condition that could be fatal if adequate, timely treatment is not administered. FNH is a benign hepatocellular neoplasm with a predilection for females. Conclusion: KMS and FNH are 2 distinct conditions that can rarely co-exist in the same patient. Corticosteroids, radiotherapy, and surgical resection are the primary modalities of treatment.

A LARGE HEPATIC HEMANGIOMA REVEALED BY EPIGASTRIC PAIN

Hepatic hemangiomas are the most common benign tumors of the liver and are often asymptomatic, diagnosed incidentally. They are considered giant when they exceed 5 cm at their largest diameter. Giant hepatic hemangiomas are rare. Diagnosis is essentially based on imaging (CT, MRI). Spontaneous or traumatic rupture, intratumor hemorrhage, rapid growth, diagnostic uncertainty and coagulopathy are the main indications for surgery. We present the case of a 53-year-old woman with two hepatic hemangiomas, the largest of which occupies the entire left lobe and measures 17 cm in diameter. It is not known how long the tumor had been growing. She underwent surgical management due to obvious mass effect.

The paediatric oncologist and the evolving medical management of complex vascular anomalies: An institutional experience

Background: Complex vascular anomalies in children are amenable to medical therapy that can result in complete resolution or improvement in cosmesis and function or serve as a conduit to definitive surgery.Aim: This study aimed to retrospectively review the management and outcomes of children with complex vascular anomalies.Setting: The study was conducted at a haematology/oncology unit based out of a paediatric hospital in the Western Cape.Methods: All patients with biopsy-proven lesions and those diagnosed on magnetic resonance imaging (MRI) from 01 January 2005 to September 2021 were considered eligible for inclusion.Results: Twenty-five patients presented with a variety of capillary, venous and lymphatic malformations. There were 11 males and 14 females, with a median age of 35 months at presentation (range: 0–156 months). Patients presented with a mass or compartmental enlargement, cutaneous stigmata or bleeding. Hepatic haemangioendotheliomas, kaposiform haemangioendotheliomas and capillary haemangiomas were most common. Kassabach-Merritt syndrome was present in 5/25 (20%) patients. Prednisone, propranolol and vincristine were the most commonly employed first-line medical treatments (15/21; 47.6%). Twelve patients received sirolimus, (11/21; 52%), four as single agent first-line therapy and eight as combination therapy, complicated by transient hyperlipidaemia in only one patient. All but one patient survived: 10 are disease free and 12 are alive with disease. Two patients with Gorham’s disease are maintained on long-term low-dose Sirolimus.Conclusion: The medical management of complex vascular anomalies yields good results in children. Sirolimus is well tolerated with few manageable side effects with cost being the only prohibitive factor to its broader application.

The application of titanium nickelide cryodestructors in the surgery of cystes and hemangiomas of the liver

The possibility of using titanium nickelide (TiNi) cryoapplicator in the surgery of nonparasitic cysts and liver hemangiomas was study.Material and methods. The analysis of the results of surgical treatment of patients with the use of TiNi cryoapplicator was carried out in 26 patients with nonparasitic liver cysts and in 31 patients with liver hemangiomas of various localization and diameter.Results. It was proved that the use of a TiNi cryoapplicator is as effective as a stationary cryoinstallation with a constant supply of a cryoagent (liquid nitrogen).Conclusion. The use of TiNi cryoapplicator increases the effectiveness of the action on cysts and hemangiomas of the liver, causing their cryodestruction and preventing the recurrence of these diseases, reduce blood loss and reduce trauma when using laparoscopic cryoprobes. In addition, when using the open access of Merzlikin– Paramonova, it becomes possible to manipulate with less trauma in the area of the diaphragmatic surface of the organ and the caval gates of the liver, which are difficult to access for surgical intervention from traditional incisions, especially when the pathological process is located in 7–8 segments of the liver.

Deep Learning-Based CT Imaging for the Diagnosis of Liver Tumor.

The objective of this research was to investigate the application value of deep learning-based computed tomography (CT) images in the diagnosis of liver tumors. Fifty-eight patients with liver tumors were selected, and their CT images were segmented using a convolutional neural network (CNN) algorithm. The segmentation results were quantitatively evaluated using the Dice similarity coefficient (DSC), precision, and recall. All the patients were examined and diagnosed by CT enhanced delayed scan technique, and the CT scan results were compared with the pathological findings. The results showed that the DSC, precision, and recall of the CNN algorithm reached 0.987, 0.967, and 0.954, respectively. The images segmented by the CNN were clearer. The diagnostic result of the examination on 56 cases by CT enhanced delay scanning was consistent with that of pathological diagnosis. According to the result of pathological diagnosis, there were 6 cases with hepatic cyst, 9 with hepatic hemangioma, 12 cases with liver metastasis, 10 cases with hepatoblastoma, 3 cases with focal nodular hyperplasia, and 18 cases with primary liver cancer. The result of CT enhanced delay scanning on 58 patients was consistent with that of pathological diagnosis, and the total diagnostic coincidence rate reached 96.55%. In conclusion, the CNN algorithm can perform accurate and efficient segmentation, with high resolution, providing a more scientific basis for the segmentation of liver tumors in CT images. CT enhanced scanning technology has a good effect on the diagnosis and differentiation of liver tumor patients, with high diagnostic coincidence rate. It has important value for the diagnosis of liver tumor and is worthy of clinical application.

Clinical evaluation of transcatheter arterial embolization combined with propranolol orally treatment of infantile hepatic hemangioma.

To assess the efficacy of transcatheter arterial embolization (TAE) plus propranolol treatment for infantile hepatic hemangioma (IHH). A retrospective study of symptomatic IHH and hemodynamic changes in IHH was conducted between 2016 and 2019. There were five boys and seven girls with diffuse lesions (n = 7) and multifocal lesions (n = 5). Hepatomegaly and abdominal distension (n = 6) were the predominant clinical presentations. Seven patients (58.3%) had multiple cutaneous hemangiomas. Pulmonary arterial hypertension, heart failure (n = 4), and hypothyroidism (n = 4) were observed. A total of 17 TAE procedures were performed in 12 IHH cases, with a technical success rate of 100%. All patients received standard propranolol orally, and one patient was orally administered metacortandracin. Two patients died of heart failure and multiple organ dysfunction caused by an enlarged liver. In addition, one patient was not reexamined after discharge. Of the remaining nine children, the average follow-up time was 10.78months (range 2-28months), and they all responded well to TAE combined with oral propranolol. TAE combined with propranolol is safe and effective for the treatment of IHH, demonstrating low complication rates.

Advantages of laparoscopic hepatic hemangioma surgery in quality of life: a prospective study.

Surgical intervention is the most accurate method for the treatment of hepatic hemangioma. The advantages of laparoscopic surgery on quality of life should be clarified by prospective studies. The sample sizes of the laparoscopic and open surgery groups were calculated based on previous retrospective literature. Intraoperative and postoperative parameters were prospectively collected and analyzed. Quality of life in both groups was predicted by a mixed linear model. Sixty patients were enrolled in the laparoscopic surgery group and open surgery group. The laparoscopic group had a longer operation time (P = 0.040) and more hospitalization expenses (P = 0.001); however, the Clavien-Dindo classification and comprehensive complication index suggested a lower incidence of surgical complications in the laparoscopic group, with P values of 0.049 and 0.002, respectively. After mixed linear model prediction, between-group analysis indicated that the laparoscopic group had little impact on role-physical functioning and role-emotional functioning; in addition, within-group analysis showed a rapid recovery time on role-physical functioning and role-emotional functioning in the laparoscopic group. Quality of life in both groups recovered to the preoperative level within 1 year after the operation. The advantages of laparoscopic hepatectomy for hepatic hemangioma were fewer postoperative complications, lower impact on quality of life and faster recovery from affected quality of life.

Application of a Tele-Ultrasound Robot During COVID-19 Pandemic: A Feasibility Study.

ObjectiveTo investigate the accuracy of ultrasonic diagnosis using the tele‐ultrasound robot in Leishen Shan Hospital.MethodTwenty‐two patients with novel coronavirus pneumonia from Leishen Shan Hospital voluntarily participated in this study. Their thyroids, neck vessels, hepatobiliaries and kidneys were scanned by both tele‐ultrasound robot manufactured by Imabot Co., Ltd, Wuhan and conventional method. The ultrasound diagnosis of each patient was compared, and the ultrasound images obtained by the two methods were mixed together and double‐blindly diagnosed by an experienced ultrasound radiologist.ResultsThere were 44 positive lesions in 110 sites of 22 patients. Of which the two methods, 40 positive lesions were detected by the robotic method with 4 lesions missed (2 small polyps of gallbladder, 1 small hemangioma of liver and 1 small cyst of kidney) and 1 lesion misdiagnosed (normal carotid artery was misdiagnosed as carotid atherosclerotic plaque); 44 positive lesions were detected by conventional method with 1 small cyst of the liver was missed. There was no statistically significant difference in the accuracy rate between the robotic method and the conventional method using the chi‐square test of the four‐grid data (P>.05).ConclusionThe application of tele‐ultrasound robot meets the standard of patient care during the pandemic. The method is feasible to provide adequate ultrasound information to diagnose common abdominal, vascular, superficial organ pathologies in patients with COVID‐19 with acceptable accuracy compared with a conventional ultrasound scan.