Impact of open and minimally invasive resection of symptomatic solid benign liver tumours on symptoms and quality of life: a systematic review. Issue 9 (September 2019)

• Record Type: Journal Article
• Authors: van Rosmalen, Belle V.; de Graeff, Jan Jaap; van der Poel, Marcel J.; de Man, Ilja E.; Besselink, Marc; Abu Hilal, Mohammad; Busch, Olivier R.; Verheij, Joanne; van Gulik, Thomas M.
• Is Part Of: HPB. Volume 21:Issue 9(2019)
• Page Start: 1119
• Page End: 1130
• Publication Date: 2019-09
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 616.362005
• DOI: 10.1016/j.hpb.2019.02.022
• Languages: English
• ISSNs: 1365-182X

Abstract

Abstract: Background: The value of open and minimally invasive liver resection for symptomatic solid benign liver tumours (BLT) such as hepatocellular adenoma, focal nodular hyperplasia and haemangioma is being debated. A systematic review on symptom relief, quality of life (QoL) and surgical outcome after both open and minimally invasive surgery for solid BLT is currently lacking. Methods: A systematic search in PubMed and EMBASE was performed according to the PRISMA guidelines (January 1985–April 2018). Articles reporting pre-and postoperative symptoms or QoL in patients undergoing open or minimally surgery for BLT were evaluated. Methodological quality was assessed using the MINORS tool. Results: Forty-two studies were included with 4061 patients undergoing surgery for BLT, 3536 (87%) open and 525 (13%) laparoscopic resections. Randomized and propensity-matched studies were lacking. Symptoms were the indication for resection in 56% of the patients. After a weighted mean of 28.5 months follow-up after surgery, symptoms were relieved in 82% of symptomatic patients. Validated QoL tools were used in eight studies, of which two found significant better QoL scores following laparoscopic compared to open surgery. Discussion: Resection of symptomatic BLT seems safe and relieves symptoms in the vast majority of selected patients. Comparative studies are needed before more firm conclusions can be drawn.