1998 Abstract: DEFINITIVE TREATMENT OF GIANT HEPATIC HEMANGIOMAS: ENUCLEATION VERSUS RESECTION. JF Buell, LB Johnson, PC Kuo, JS Plotkin, R Gedaly-Eidelman, WD Lewis, RL Jenkins. University of Maryland, School of Medicine, Baltimore, Maryland, Beth Israel-New England Deaconess, Harvard Medical School, Boston, Massachusetts. 131
Abstracts 1998 Digestive Disease Week
#1035
DEFINITIVE TREATMENT OF GIANT HEPATIC HEMANGIOMAS: ENUCLEATION VERSUS RESECTION. JF Buell, LB Johnson, PC Kuo, JS Plotkin, R Gedaly-Eidelman, WD Lewis, RL Jenkins. University of Maryland, School of Medicine, Baltimore, Maryland, Beth Israel-New England Deaconess, Harvard Medical School, Boston, Massachusetts.
Sporadic success has been reported with the management of giant hepatic hemangiomas (>4cm.) by non-surgical techniques. However, surgical extirpation is usually required for definitive treatment. The decision to embark upon surgical treatment must be balanced between the severity of symptoms and the operative risks. Recently, enucleation of giant hepatic hemangiomas has been reported as a procedure that may result in less blood loss, shorter operative times and shorter hospital stays compared to standard hepatic resection. Methods; The outcomes of 24 consecutive patients undergoing enucleation (enuc) were compared to 13 age- matched controls undergoing standard resection (resect) for giant hepatic hemangiomas. Data are expressed as mean ± SEM. Results; The location of the hemangiomas were predominantly right lobe; 12/13 (resect) vs. 19/24 (enuc). In the resect group 2 patients underwent segmental resection, 2 patients underwent trisegmentectomies and the remaining 9 underwent standard right or left lobectomies. Survival was 100% in both groups. Size of the tumors were similar in both groups.
Resect
Enuc
P- value
Age (years)
43.4 ± 1.98
47.3 ± 2.7
NS
Hospital Stay (days)
11.1 ± 1.57
8.25 ± 0.78
NS
OR time (hours)
5.13 ± 0.35
3.55 ± 0.27
0.001*
PRBC (units)
1.85 ± 0.58
2.83 ± 1.30
NS
ICU stay (days)
0.93 ± 0.21
0.62 ± 0.43
NS
Vent Need (days)
0.15 ± 0.10
0.29 ± 0.14
NS
Complications
7/13
8/24
NS
*P < 0.05 considered insignificant; NS = not significant
Conclusion; The surgical management of giant hepatic hemangiomas with either resection or enucleation demonstrates similar operative and post- operative results. Enucleation is associated with significantly shorter operative times. A larger study is required to validate these data.
Copyright 1996 - 1998, SSAT, Inc. Revised 29 June 1998.
