The challenge of liver resection in benign solid liver tumors in modern times - in which cases should surgery be done?

作者：Hau Hans Michael^*; Kloss Anne; Wiltberger Georg; Jahn Nora; Krenzien Felix; Benzing Christian; Schmelzle Moritz; Seehofer Daniel; Atanasov Georgi; Bartels Michael

来源：Zeitschrift für Gastroenterologie, 2017, 55(7): 639-652.

DOI：10.1055/s-0043-110145

• liver resection
• quality of life
• diagnostical algorithm
• benign liver tumor

Background Due to improved diagnostical and therapeutical approaches, benign liver tumors represent a challenge in clinical management. We here report our experience with patients undergoing liver resection for benign liver tumors.
Methods 188 One hundred eighty-eight consecutive patients, who underwent surgery for solid benign liver tumors from 1992-2014, were analyzed retrospectively. The focus was on diagnostic pathways, indications for surgery, and perioperative and postoperative quality of life (QoL).
Results Of 188 patients, 100 had focal nodular hyperplasia (FNH) (53.2 %), 33 had hepatocellular adenoma (17.5 %), and 55 had hemangioma (29.3 %). In most patients, there was more than one 1 indication for liver resection, including tumor-associated symptoms (n = 82, 43.6 %), suspicion of malignancy (n = 104, 55.3 %), tumor disease in the medical history (n = 48, 25.5 %), or tumor enlargement (n = 27, 14.4 %). Serious complications (> grade III;, Clavien-Dindo) occurred in 9.5 % of patients. Perioperative mortality was 0.5 %. Patient pain scores decreased over time (p < 0.001). QoL after liver resection significantly improved (p = 0.007).
Conclusion Uncertainty of the tumor entity remains an issue in preoperative diagnostics. If indicated, liver resection for benign liver tumors represents a safe approach and leads to significant improvements of QoL.

• 出版日期2017-7