This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (23)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Ultrasonography  • Alert me on articles by topic  Social Bookmarking   What's this?

Anatomic Resection vs Enucleation

Roberto Gedaly, MD; James J. Pomposelli, MD, PhD; Elizabeth A. Pomfret, MD, PhD; W. David Lewis, MD; Roger L. Jenkins, MD

Arch Surg. 1999;134:407-411.

Hypothesis  Patient outcome and the development of major intra-abdominal postoperative complications following removal of cavernous hemangiomas of the liver are affected by methods of resection.

Design  Case-control study.

Setting  Hepatobiliary surgery and liver transplantation unit in a tertiary care referral medical center.

Patients  Between December 1, 1987, and December 1, 1997, 28 patients underwent the surgical removal of cavernous hemangioma either by hepatic resection or enucleation. Indications for the operation were pain, enlarging tumors, uncertain diagnosis, or rupture.

Main Outcome Measures  The technique of tumor removal, hospital course, and the development of intra-abdominal complications. Independent factors influencing the development of complications were ascertained by multivariate analysis.

Results  Twenty-four female and 4 male patients (age, 47.5±12.4 [mean±SD] years) underwent either enucleation (n=23) or liver resection (n=5). Lesions ranged from 2 to 16 cm in their postresection diameter. No surgical (30-day) mortality was observed. Four major intra-abdominal complications were found: 1 episode of intraoperative bleeding requiring abdominal packing and 3 intra-abdominal fluid collections requiring percutaneous drainage. Enucleation was the only independent factor found by univariate and multivariate analyses to be associated with a reduction in the number of intra-abdominal complications (P=.04).

Conclusions  Cavernous hemangiomas of the liver can be removed safely by either hepatic resection or enucleation. Enucleation is associated with fewer intra-abdominal complications and should be the technique of choice when tumor location and technical factors favor enucleation.

From the Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Image of the Month--Diagnosis
Arch Surg 2007;142:400-400.
FULL TEXT  

Giant Cavernous Liver Hemangiomas: Effect of Operative Approach on Outcome
Lerner et al.
Arch Surg 2004;139:818-823.
ABSTRACT | FULL TEXT  

Indications and Long-term Outcome of Treatment for Benign Hepatic Tumors: A Critical Appraisal
Terkivatan et al.
Arch Surg 2001;136:1033-1038.
ABSTRACT | FULL TEXT