Indokolt-e a jóindulatú májdaganatok sebészi kezelése?: Saját tapasztalatok és irodalmi áttekintés

BACKGROUND AND AIMS: Our aim is to give an audit of our experience over the past two decades in the form of a retrospective study. PATIENTS/METHODS: Between 1 January, 1982 and 15 December, 2001, 133 patients with benign liver tumor (adenoma: 22, focal nodular hyperplasia: 27, hemangioma: 83, lipoma: 1) were treated. A total of 113 patients underwent surgery, while 20 asymptomatic cases were merely observed. The mean age, the female/male ratio and the size of the tumor in the adenoma cases were 38.3+/-10.2 years, 20/2 and 7.7+/-2.4 cm, while for focal nodular hyperplasia they were 39.5+/-12.4, 24/3 and 6.3+/-2.7 cm, and for hemangioma 49.01+/-10.7, 62/21 and 6.5+/-3.6 cm. The results were compared and analyzed statistically. RESULTS: Enucleation was performed in 53.1% of the patients, non-anatomical resection in 24.8%, segmentectomy in 6.2%, lobectomy in 4.4%, extended lobectomy in 1.8%, stitching in 5.3%, exploration in 3.5% and liver transplantation in 0.9%. The overall 30-day postoperative mortality was 0.9% (1/113). Minor or major complications occurred in a total of 27.4%. CONCLUSIONS: Patients with asymptomatic focal nodular hyperplasia or hemangiomas must be excluded from surgery. Surgery is indicated only when growth or severe complaints are observed. Adenomas must be resected because of the precancerous behavior and the danger of bleeding from a rupture.