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Shanghai Renji Hospital successfully operated to remove a 6 kg giant hemangioma in the liver http://www.sina.com.cn June 08, 2010 20:33 Sina Shanghai Health Organ Transplantation Department of Renji Hospital, Shanghai Jiaotong University School of Medicine, successfully removed a giant hemangioma in the liver weighing 6 kg with a diameter of nearly 45 cm for the first time, saving the patient’s The patient’s liver was partially saved from liver transplantation. Xia Lei, Liver Surgery Department, Shanghai Renji Hospital According to the introduction, the use of precise liver resection surgery, the most thorough removal of lesions, the least trauma, the maximum protection of liver function protection as well as the fastest health recovery treatment concept is the development direction of modern complex liver surgery.　　It is known that this patient accidentally discovered liver hemangioma 26 years ago and did not have surgery at that time. 10 years ago, the hemangioma had reached 15 cm and had multiple occurrences when he was re-examined, and in the past three years, the hemangioma continued to grow, the abdominal distension was unbearable, and the body was deteriorating.　　During the examination, experts from Renji Hospital found that the patient’s liver was covered with 5 or 6 large and small hemangiomas, the largest of which was nearly 45 cm in diameter, equivalent to the size of 5-6 normal livers by volume. Experts told the reporter that because the hemangioma tightly wrapped around the liver gate and important large blood vessels in the abdominal cavity, although liver transplantation can be performed to remove the hemangioma including normal liver tissue, but after the operation, the patient is faced with lifelong immunosuppressive therapy, which reduces the quality of life and imposes a large economic burden. If hemangioma resection is implemented, the patient will suffer from fatal liver failure once it fails because the hemangioma grows and adheres to normal liver tissue.　　After repeated discussions, the medical staff developed a bold surgical plan of “partial hepatectomy with the technique of living liver transplantation and the concept of precise hepatectomy”. Xia Qiang, director of the hospital’s organ transplantation department, told reporters that the entire surgery, which took six hours, was carried out on May 18, with the expert’s delicate work, removing 6 kilograms of hemangioma-like tissue and preserving 50% of the liver tissue. The patient’s post-operative abdominal circumference was reduced from 110cm to 74cm before the surgery, which saved the patient huge medical expenses and avoided follow-up treatment.　　Experts say that with the continuous development of living liver transplantation, the precision hepatectomy approach is being promoted by more and more hepatic surgeons. In complex liver surgery, it can improve the radical resection rate of liver tumors and the safety of surgery, reduce the traumatic blow to the organism and the incidence of complications, and greatly improve the prognosis and quality of life of liver surgery patients. Attachment: This 2010 news article reported a real case in our department and a patient under my management, which was particularly impressive. This patient had a large abdomen like a pregnant woman before surgery, with ascites, anemia, low protein, and lower limb edema, and often required blood and protein transfusions in the hospital, and was usually bedridden and unable to take care of herself at home. Of course, after the superb surgery and careful treatment in our department, she recovered and was discharged 2 weeks after the surgery. After the surgery, her abdominal circumference shrank significantly, her ascites completely disappeared, her liver function was normal, and she could not only take care of herself, but also do housework and even go to the park to participate in exercise activities, and her quality of life improved significantly.    This case certainly reflects the magic of surgical technology, but it also gives us two important warnings: 1. Liver hemangioma must be reviewed regularly to understand its growth rate. It is believed that although hepatic hemangiomas grow slowly in general, they may grow faster at some point, so a 6-monthly interval for liver ultrasound review is appropriate.    2. The timing of hepatic hemangioma surgery must be well-timed. In this patient, the hemangioma was not large when it was discovered more than 20 years ago, so surgery should have been relatively simple at that time, but now it has become a “minefield” that no one dares to step into after missing the time. Therefore, there is a “degree” of when to operate for hepatic hemangioma, and this “degree” is not just to look at the diameter of the hemangioma and not to operate if it is smaller or larger. The decision will be made by the doctor based on the location of the hemangioma, its relationship with the liver vessels and bile ducts. Especially in today’s widespread laparoscopic liver resection, the surgery is significantly less traumatic than traditional methods, and the hospitalization time is shorter and the aesthetic effect is better without surgical scars, so it is possible to solve the problem at an earlier stage, so as not to “feed the tiger” like this patient.