肝脏海绵状血管瘤的外科治疗

Surgical therapy for 114 cases of the hepatic cavernous hemangioma

目的 探讨肝脏海绵状血管瘤的手术指征和手术方式。方法 回顾性分析手术治疗114例肝脏海绵状血管瘤病人临床资料。结果 79例采用血管瘤剜除术 (其中 1例合并有Kasabach -Merritt综合症 ) ,2 9例肝叶或肝段切除术 ,5例多发性血管瘤行联合肝段切除术、血管瘤剥离和缝扎术 ,1例采用酒精注射法。结论 对肝脏海绵状血管瘤直径 >6cm并有明显临床症状或患者精神负担较重 ,或合并需手术的其他上腹部外科疾病者选择手术切除 ;直径≥

Objective To evaluate the elective surgical indications and procedures for liver hemangiomas.Methods One hundred and fourteen patients with the hepatic cavernous hemangiomas treated surgically were retrospectively analyzed.Results Seventy-nine patients underwent hemangioma enucleation,29 were treated with hepatic lobectomy or segmentectomy,5 cases of multiple hemangiomas were subjected to segmentectomy,dissection of hemangioma and transfixion,and the remaining one received alcohol injection.The operative complications occurred in 12 cases.The pleural effusions were the common complications.Conclusion Surgical management is indicated for the hepatic cavernous hemangioma as follows:the tumor size exceeds 6 cm in diameter in combination with clinical manifestation,or significant distress;the tumor diameter is ≥10 cm or tumor increased in size during follow-up,and uncertain diagnosis with a suspicion of malignancy.