1. The Two-Step Treatment for Giant Hepatic Hemangiomas
- Author
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Diego Palumbo, Simone Gusmini, Luca Aldrighetti, Francesca Ratti, Massimo Venturini, Rebecca Marino, Giorgia Guazzarotti, Angelo Della Corte, Francesco De Cobelli, Federica Cipriani, Luigi Augello, Guido Fiorentini, Della Corte, A., Marino, R., Ratti, F., Palumbo, D., Guazzarotti, G., Gusmini, S., Augello, L., Cipriani, F., Fiorentini, G., Venturini, M., Aldrighetti, L., and De Cobelli, F.
- Subjects
Laparoscopic surgery ,medicine.medical_specialty ,giant hepatic hemangioma ,business.industry ,medicine.medical_treatment ,Giant hepatic hemangioma ,Radiologic arterial embolization ,Two step ,General Medicine ,Successful completion ,laparoscopic surgery ,Article ,Group B ,Surgery ,Blood loss ,Maximum diameter ,Laparotomy ,medicine ,Medicine ,radiologic arterial embolization ,Embolization ,business - Abstract
The aim of the present study is to analyze the feasibility and the impact of a two-step approach in the treatment of giant hemangiomas (GH) i.e., exceeding 10 cm in maximum diameter, consisting of transarterial embolization (TAE) followed by laparoscopic liver resection (LLR). Ten patients with 11 GH were treated with TAE and subsequent LLR between 2017 and 2020 (Group A). A matched cohort of 10 patients with GH treated with upfront LLR between 2014 and 2017 was identified for comparison (Group B). Data were analyzed regarding intraoperative and postoperative outcomes, including successful completion of LLR, morbidity, and mortality. Successful microparticle embolization of the GH-feeding arteries was performed in all patients in group A. In three cases a liquid embolic agent (Squid-18) was also injected to obtain complete embolization. No complications were observed after TAE. Successful surgery was performed after a mean time interval of 2.2 days from TAE without any case of conversion to laparotomy. Statistically significant differences between group A and group B were found in intraoperative blood loss (250 ± 200 vs. 400 ± 300 mL, p = 0.039), operative time (245 ± 60 vs. 420 ± 60 min, p = 0.027), and length of stay (5 ± 1 vs. 8 ± 2 days, p = 0.046). Our data suggest that two-step TAE + LLR might be a safe and effective option for surgical treatment of GH >, 10 cm.
- Published
- 2021