Surgery of benign liver tumors: indications for treatment: twenty years' experience

BACKGROUND/AIMS: The aim of this study is to give an audit of the experiences in the Institute of Experimental Surgery, at the University of Szeged, over the past 2 decades in the form of a retrospective study. METHODOLOGY: Between January 1982 and December 2001, 132 patients with benign liver tumor (adenoma: 22; focal nodular hyperplasia: 27; hemangioma: 83) were treated. A total of 112 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 38.2 years, 20/2 and 7.7cm, while for focal nodular hyperplasia they were 39.4, 24/3 and 6.3cm, and for hemangioma 49.0, 62/21 and 6.5cm. The results were compared and analyzed statistically. RESULTS: Enucleation was performed in 45.4% of the patients, nonanatomical resection in 35.6%, segmentectomy in 7%, lobectomy in 3.8%, extended lobectomy in 1.5%, stitching in 4.5%, exploration in 2.3% and liver transplantation in 0.8%. The mortality was 0.8%. Complications occurred in a total of 23.5% of the cases. 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.