Surgical Treatment Of Giant Hemangioma Research Articles

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

Backgrounds/AimsLiver 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.MethodsNine 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.ResultsThe 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.ConclusionsThe 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.

Surgical treatment of giant hemangiomas of the liver

Giant liver hemangiomas are defined as hemangiomas with a diameter of more than 4 cm. They often require surgery due to bleeding tendencies or local compression. Between 1994 and 1998 we operated 11 patients with giant hemangiomas (median diameter 5.8 cm, range 4-12.5 cm). Average age was 50 years (range 23-85 years). 6 patients complained of pain, 1 patient sustained a bleeding. 7 hemangiomas were enucleated, 2 segmentally resected, 1 patient underwent a hemihepatectomy. 1 patient suffered from a bile leakage. Mortality was 0%. We conclude that clinically symptomatic liver hemangiomas can be safely resected. In a right sided localisation a enucleation has the best parenchyma sparing effect, in left sided locations a segmentectomy or bisegmentectomy can be performed with little blood loss.

Surgical treatment of giant hemangioma of the liver

During a 5 year period, we treated 5 patients with giant hemangioma of the liver. There were 4 women and 1 man who ranged in age from 34 to 51 years with an average age of 43.8 years. The symptoms were an abdominal mass with Kasabach-Merritt syndrome in 2 patients, an uncomfortable sensation in the upper abdomen in two patients, and pain in the right upper quadrant in one patient. All five patients underwent surgical treatment with a successful outcome. Three of the patients underwent hepatic lobectomy, one patient underwent left lateral segmentectomy with ligation of the right hepatic artery, and one patient had ligation of the left hepatic artery with radiation. In two of the patients, Kasabach-Merritt syndrome was cured promptly after hepatic lobectomy. We believe that a symptomatic giant hemangioma within one lobe should be treated by hepatectomy, but if it involves both lobes, ligation of the hepatic artery, with or without radiation, should be considered.

Surgical treatment of giant hemangioma of the facial region after arterial embolization: Josef Schrudde andVeronika Petrovici. Plast Reconstr Surg 68:878–889, (December), 1981

Surgical treatment of giant hemangioma of the facial region after arterial embolization: Josef Schrudde andVeronika Petrovici. Plast Reconstr Surg 68:878–889, (December), 1981

Surgical Treatment of Giant Hemangioma of the Facial Region after Arterial Embolization

Schrudde, Josef M.D.; Petrovici, Veronika M.D.; Hoopes, John E. M.D. Author Information