Öz
Fokal nodüler hiperplazi (FNH) genellikle opere edilmez. Tanısal zorluklar ve semptomatik lezyonlar cerrahi için yaygın endikasyonlardır. Bu
çalışma, karaciğer ameliyatları sonrası patoloji sonucu FNH olarak raporlanan olgularda ameliyat endikasyon ve sonuçlarının incelenmesi amacıyla
yapılmıştır. Ekim 2009-Mart 2018 tarihleri arasında Ankara Üniversitesi Hastaneleri’nde opere edilen ve patolojisi FNH olarak raporlanan hastalar
incelendi. Hastaların 12’sinde bazı karın semptomları vardı, dördünde ise herhangi bir semptom rapor edilmedi. Tüm hastalara bilgisayarlı tomografi,
ultrasonografi veya manyetik rezonans görüntülemeden en az bir görüntüleme yöntemi uygulandı. Sadece üç hastaya kesin FNH tanısı konuldu
ve bu hastalar aynı zamanda semptomatikti. Ameliyat öncesi grupta sarılık görülmedi. Sadece bir hastada ameliyat öncesi hafif yüksek karaciğer
enzim seviyeleri görüldü. Pankreatoduodenektomi ve kolesistektomi gibi ek prosedürler uygulanan iki hasta dışında tüm hastalara çeşitli tiplerde
hepatektomi uygulandı. Hastaların sadece üçünde intraabdominal apse, safra kaçağı ve pulmoner emboli gibi postoperatif komplikasyonlar gelişti.
Mortalite izlenmedi. FNH olgularında cerrahi nadiren gereklidir. Ancak lezyonun FNH dışında bir lezyon olduğundan şüphelenildiğinde ve hasta
semptomatikse genellikle cerrahi yaklaşım tercih edilir.
Anahtar Kelimeler
Fokal Nodüler Hiperplazi Premalign Lezyon Benign Hastalık Hepatektomi
Etik Beyan
Hastaların radyolojik ve klinik özellikleri retrospektif olarak incelendi.
Destekleyen Kurum
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Proje Numarası
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Teşekkür
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Kaynakça
- 1. Nahm CB, Ng K, Lockie P, et al. Focal nodular hyperplasia—a review of myths and truths. J Gastrointest Surg. 2011;15:2275-2283.
- 2. Perrakis A, Demir R, Müller V, et al. Management of the focal nodular hyperplasia of the liver: evaluation of the surgical treatment comparing with observation only. Am J Surg. 2012;204:689-696.
- 3. Chen MF. Hepatic resection for benign tumours of the liver. J Gastroenterol Hepatol. 2000;15:587-592.
- 4. Jung JM, Hwang S, Kim KH, et al. Surgical indications for focal nodular hyperplasia of the liver: Single-center experience of 48 adult cases. Ann Hepatobiliary Pancreat Surg. 2019;23:8-12.
- 5. Nguyen BN, Fléjou JF, Terris B, et al. Focal nodular hyperplasia of the liver: a comprehensive pathologic study of 305 lesions and recognition of new histologic forms. Am J Surg Pathol. 1999;23:1441-1454.
- 6. Vilgrain V. Focal nodular hyperplasia. Eur J Radiol. 2006;58:236-245.
- 7. Navarro AP, Gomez D, Lamb CM, et al. Focal nodular hyperplasia: a review of current indications for and outcomes of hepatic resection. HPB (Oxford). 2014;16:503-511.
- 8. Bonney GK, Gomez D, Al-Mukhtar A, et al. Indication for treatment and long-term outcome of focal nodular hyperplasia. HPB (Oxford). 2007;9:368-372.
Öz
Surgery is rarely a necessity for the removal of focal nodular hyperplasia (FNH) lesions. Diagnostic challenges and symptomatic lesions are common
indications for surgery. This study was conducted for the purposes of analyzing the indications and results of liver surgeries, revealing FNH in further
examinations from specimens sent to pathology. The patients that were operated for liver lesions revealed as FNH at pathological examinations at
Ankara University Hospitals between October 2009 and March 2018 were included in this study. Twelve of the patients had some abdominal symptoms,
with the remaining four having no reported symptoms. All patients were subjected to at least one imaging modality from computed tomography,
ultrasonography or magnetic resonance imaging. Only three patients were diagnosed with certain FNH and were also symptomatic. No jaundice
was observed in the group before surgery. Only one patient demonstrated mildly elevated preoperative liver enzyme levels. All patients underwent
several types of hepatectomies except for two patients undergoing additional procedures such as pancreatoduodenectomy and cholecystectomy.
Only three of the patients had postoperative complications including intraabdominal abscess, biliary leak and pulmonary embolism. No mortality
occurred among the group. Surgery is rarely a necessity in the cases of FNH. However, surgical approach is generally preferred when the lesion is
suspected to be a lesion other than FNH.
Anahtar Kelimeler
Focal Nodular Hyperplasia Premalignant Lesion Benign Disease Hepatectomy
Etik Beyan
-
Destekleyen Kurum
-
Proje Numarası
-
Teşekkür
-
Kaynakça
- 1. Nahm CB, Ng K, Lockie P, et al. Focal nodular hyperplasia—a review of myths and truths. J Gastrointest Surg. 2011;15:2275-2283.
- 2. Perrakis A, Demir R, Müller V, et al. Management of the focal nodular hyperplasia of the liver: evaluation of the surgical treatment comparing with observation only. Am J Surg. 2012;204:689-696.
- 3. Chen MF. Hepatic resection for benign tumours of the liver. J Gastroenterol Hepatol. 2000;15:587-592.
- 4. Jung JM, Hwang S, Kim KH, et al. Surgical indications for focal nodular hyperplasia of the liver: Single-center experience of 48 adult cases. Ann Hepatobiliary Pancreat Surg. 2019;23:8-12.
- 5. Nguyen BN, Fléjou JF, Terris B, et al. Focal nodular hyperplasia of the liver: a comprehensive pathologic study of 305 lesions and recognition of new histologic forms. Am J Surg Pathol. 1999;23:1441-1454.
- 6. Vilgrain V. Focal nodular hyperplasia. Eur J Radiol. 2006;58:236-245.
- 7. Navarro AP, Gomez D, Lamb CM, et al. Focal nodular hyperplasia: a review of current indications for and outcomes of hepatic resection. HPB (Oxford). 2014;16:503-511.
- 8. Bonney GK, Gomez D, Al-Mukhtar A, et al. Indication for treatment and long-term outcome of focal nodular hyperplasia. HPB (Oxford). 2007;9:368-372.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Genel Cerrahi |
| Bölüm | Makaleler |
| Yazarlar | |
| Proje Numarası | - |
| Yayımlanma Tarihi | 18 Ekim 2022 |
| Yayımlandığı Sayı | Yıl 2022 Cilt: 75 Sayı: 3 |
