Pure laparoscopic liver resection for giant liver hemangioma with extrahepatic growth based on preoperative 3-dimensional simulation: A case report

Okumura, Yoshitomo; Noda, Takehiro; Eguchi, Hidetoshi; Hanaki, Takehiko; Iwagami, Yoshifumi; Akita, Hirofumi; Asaoka, Tadafumi; Gotoh, Kunihito; Kobayashi, Shogo; Umeshita, Koji; Mori, Masaki; Doki, Yuichiro

doi:10.1186/s40792-019-0607-8

Cited by 4 publications

(3 citation statements)

References 14 publications

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“…Pre-operative TAE prior to LLR of GHs has only been described in a few case reports [ 7 , 8 , 9 ]. However, given the anecdotal nature of these studies, no consistent information is provided regarding the embolizing materials, limiting the reproducibility of these data.…”

Section: Discussionmentioning

confidence: 99%

“…Some case series of successful laparoscopic liver resections (LLRs) for selected hepatic hemangiomas are currently available in the literature [ 6 , 7 , 8 , 9 , 10 , 11 , 12 ] yet all authors highlight several technical difficulties; high rates of conversion to open surgery and massive intraoperative blood loss are the most challenging. In addition, there is growing evidence that size itself is among the most important risk factors associated with uncontrollable bleeding and limited intrabdominal surgical workspace [ 2 , 13 , 14 ], making LLR a particularly challenging choice for the treatment of GHs exceeding 10 cm.…”

Section: Introductionmentioning

confidence: 99%

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The Two-Step Treatment for Giant Hepatic Hemangiomas

Corte

Marino

Ratti

et al. 2021

JCM

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Two-Step Treatment for Giant Hepatic Hemangiomas

Corte

Marino

Ratti

et al. 2021

JCM

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“…The introduction of surgical robot has overcome many of the shortcomings of traditional laparoscopic surgery [15] by providing high definition three-dimensional visualization, EndoWrist instruments with 7 degrees of freedom of motion, and tremor filtration. Cohort studies on robot-assisted and/or laparoscopic liver resection for hemangioma have been reported, but most of these studies are small case series or case reports [16][17][18][19][20]. To our knowledge, there have been no studies directly comparing robot-assisted liver resection (RALR) versus laparoscopic liver resection (LLR) for liver hemangiomas.…”

mentioning

confidence: 99%

Perioperative outcomes of robot-assisted versus laparoscopic liver resection for cavernous hemangioma: a propensity score matching study

et al. 2023

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Background Minimally invasive techniques have increasingly been adopted for liver resection. This study aimed to compare the perioperative outcomes of robot-assisted liver resection (RALR) with laparoscopic liver resection (LLR) for liver cavernous hemangioma and to evaluate the treatment feasibility and safety. Methods A retrospective study of prospectively collected data was conducted on consecutive patients who underwent RALR (n = 43) and LLR (n = 244) for liver cavernous hemangioma between February 2015 and June 2021 at our institution. Patient demographics, tumor characteristics, and intraoperative and postoperative outcomes were analyzed and compared using propensity score matching. Results The postoperative hospital stay was significantly shorter (P = 0.016) in the RALR group. There were no significant differences between the two groups in overall operative time, intraoperative blood loss, blood transfusion rates, conversion to open surgery or complication rates. There was no perioperative mortality. Multivariate analysis showed that hemangiomas located in posterosuperior liver segments and those in close proximity to major vascular structures were independent predictors of increased intraoperative blood loss (P = 0.013 and P = 0.001, respectively). For patients with hemangioma in close proximity to major vascular structures, there were no significant differences in perioperative outcomes between the two groups, with the exception that intraoperative blood loss in the RALR group was significantly less than that in the LLR group (350 ml vs. 450 ml, P = 0.044). Conclusions Both RALR and LLR were safe and feasible for treating liver hemangioma in well-selected patients. For patients with liver hemangioma in close proximity to major vascular structures, RALR was better than conventional laparoscopic surgery in reducing intraoperative blood loss.

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Study on the Mechanism of Targeted Poly(lactic-co-glycolic acid) Nano-Delivery Carriers in the Treatment of Hemangiomas

Liao

et al. 2021

j nanosci nanotechnol

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Hemangiomas, also called infantile hemangiomas (IH), are the most common congenital benign vascular tumors in infants and young children. At present, there are many treatment methods for proliferative hemangiomas, which have different effects and lack predictability. Propranolol has gradually replaced glucocorticoids as the first-line treatment for infants and young children with hemangiomas. However, premature discontinuation is prone to relapse, and the efficacy and safety of medication need to be further studied and determined. The exact pathogenesis of hemangiomas is still unclear. Therefore, in this study, poly(lactic-co-glycolic acid) (PLGA) nanoparticles were used as drug delivery carriers, propranolol was encapsulated, and PLGA-propranolol (PLGA-PP) nanodelivery preparations were prepared and targeted. Anisotropy and pharmacokinetics were preliminary studied. At the same time, after the treatment of HemECs cells with PLGA-PP in gradient concentration in vitro, CCK-8 method was used to detect the cell proliferation, and Anyixin-V/PI double staining method was used to detect the apoptosis rate of cells. The effect of PLGA-PP nano-delivery vector on hemangioma was studied by western blot method to detect the expression level of Id-1 protein in HemECs. The results showed that after PLGA-PP treated HemECs for 24 h, PLGA-PP significantly inhibited HeECs proliferation and promoted their apoptosis, and the intracellular Id-1 protein expression was also reduced. Therefore, this study believes that the mechanism of PLGA-PP nano-targeted delivery preparations in the treatment of hemangiomas is achieved by down-regulating the Id-1 gene, thereby inhibiting the colonization of HemECs and promoting its apoptosis effect.

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Pure laparoscopic liver resection for giant liver hemangioma with extrahepatic growth based on preoperative 3-dimensional simulation: A case report

Cited by 4 publications

References 14 publications

The Two-Step Treatment for Giant Hepatic Hemangiomas

The Two-Step Treatment for Giant Hepatic Hemangiomas

Perioperative outcomes of robot-assisted versus laparoscopic liver resection for cavernous hemangioma: a propensity score matching study

Study on the Mechanism of Targeted Poly(lactic-co-glycolic acid) Nano-Delivery Carriers in the Treatment of Hemangiomas

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