Efficacy and factors affecting the choice of enucleation and liver resection for giant hemangioma: a retrospective prope
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RESEARCH ARTICLE
Open Access
Efficacy and factors affecting the choice of enucleation and liver resection for giant hemangioma: a retrospective propensity score‑matched study Mingguang Ju, Feng Xu, Wenyan Zhao and Chaoliu Dai*
Abstract Background: Liver resection (LR) and enucleation (EN) are the main surgical treatment for giant hepatic hemangioma (HH), but how to choose the type of surgery is still controversial. This study aimed to explore the efficacy and the factors affecting the choice of open procedure for HH. Methods: The data for patients with pathologically confirmed HH who underwent open surgery from April 2014 to August 2020 were analyzed retrospectively. Univariate and multivariate analyses with logistic regression were performed to disclose the factors associated with the choice of EN or LR. Propensity score matching (PSM) analysis was used to compare the efficacy of the two procedures. Results: A total of 163 and 110 patients were enrolled in the EN and LR groups. Following 1:1 matching by PSM analysis, 66 patients were selected from each group. Centrally located lesions (OR: 0.131, 95% CI 0.070–0.244), tumors size > 12.1 cm (OR: 0.226, 95% CI 0.116–0.439) and multiple tumors (OR: 1.860, 95% CI 1.003–3.449) were independent factors affecting the choice of EN. There was no significant difference in the median operation time (156 vs. 195 min, P = 0.156), median blood loss (200 vs. 220 ml, P = 0.423), blood transfusion rate (33.3% vs. 33.3%, P = 1.000), mean postoperative feeding (3.1 vs. 3.3 d, P = 0.460), mean postoperative hospital stay (9.5 vs. 9.0 d, P = 0.206), or the major complication rates between the two groups. Conclusions: Peripherally located lesions, tumors size ≤ 12.1 cm and multiple tumors were more inclined to receive EN. There was no significant difference in the efficacy of EN or LR. Keywords: Hepatic hemangioma, Enucleation, Liver resection, Propensity score matching, Surgery Background Hepatic hemangioma (HH) is the most common benign tumor of the liver [1]. Most patients with HH are asymptomatic and the lesions are incidentally detected on ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) [2]. Small asymptomatic HH *Correspondence: [email protected] Department of General Surgery, Shengjing Hospital of China Medical University, No.36 Sanhao Street, Heping District, Shenyang 110004, Liaoning, China
(generally 12.1 were 0.253 times less likely to undergo EN than tumors ≤ 12.1 cm) and multiple tumors (OR:
Ju et al. BMC Surg
(2020) 20:271
Page 6 of 9
Table 1 Demographics, comorbidities, and pre-operative data for patients undergoing surgery for hepatic hemangioma Variable
Before propensity EN
After propensity LR
P value
Number of patients (%)
163 (100)
110 (100)
Age (years)
47.3 ± 9.0
49.0 ± 10.2
0.154 0.481
EN
LR
P value
66 (100)
66 (100)
47.6 ± 9.4
47.0 ± 9.0
0.693 0.691
Gender Female
124 (76.1)
79 (71.8)
Male
39 (22.9)
31 (28.2)
23.3 ± 3.5
23.4 ± 3.0
BMI (kg/m2)
0.817
50 (75.8)
48 (72.7)
16 (24.2)
18 (27.3)
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