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Indications for liver surgery in benign tumours

Author:
Fodor, Margot  Primavesi, Florian  Braunwarth, Eva  Cardini, Benno  Resch, Thomas  Bale, Reto  Putzer, Daniel  Henninger, Benjamin  Oberhuber, Rupert  Maglione, Manuel  Margreiter, Christian  Schneeberger, Stefan  Oefner, Dietmar  Staettner, Stefan  


Journal:
EUROPEAN SURGERY-ACTA CHIRURGICA AUSTRIACA


Issue Date:
2018


Abstract(summary):

Background Management of benign liver tumours (BLT) is still object of discussion. Uncertainty still exists about patient selection, details of management, indications for surgical intervention and potential surgery-related complications. The up-to-date strategies for management of the most common benign solid tumours are recapitulated in this article. In addition, recommendations concerning practical issues are presented. Methods Available data from peer-reviewed publications associated with the major controversies concerning treatment strategies of solid BLT were selected through a PubMed literature search. Results Non-randomized controlled trials, retrospective series and case reports dominate the literature. Conservative management in BLT is associated with low overall morbidity and mortality when applied in an appropriate patient population. Surgical intervention is indicated solely in the presence of progressive symptoms and suspicion of a malignant change. Linking abdominal symptoms to BLT should be interpreted with caution. No evidence is recorded for malignant transformation in haemangiomas and focal nodular hyperplasia (FNH), while a subgroup of hepatocellular adenoma (HCA) is associated with malignancy. Follow-up controls of BLT at 3 and 6 months should be sufficient to prove the stability of the lesion and its benign nature, after which no long-term follow-up is required routinely, However, many questions regarding this topic remain without definitive answers in the literature. Conclusion Conservative management of solid BLT is a worldwide trend, but the available literature does not provide high-grade evidence for this strategy. Consequently, further prospective investigations on the unclear aspects are required. Lienee, this article summarises practical highlights of therapeutic strategies.


Page:
125---131


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