Abstract: Objective:To evaluate the postoperative quality of life after surgery of patients with hepatic hemangioma.
Methods:The retrospective and descriptive study was conducted. The clinical data of 104 patients who underwent surgery for hepatic hemangioma at Shengjing Hospital of China Medical University from September 2011 to February 2017 were collected. There were 28 males and 76 females, aged (49±8)years, with a range of 27-78 years. Enucleation of hepatic hemangioma or hepatectomy was selected according to tumor location of patients. Observation indicators: (1) surgical and postoperative situations; (2) assessment of quality of life in patients; (3) assessment of quality of life in patients comorbid with other chronic digestive diseases. Measurement data with normal distribution were represented as Mean±SD, and measurement data with skewed distribution were represented as M (range). Repeated data were analyzed using repeated ANOVA. Count data were represented as absolute numbers.
Results:(1) Surgical and postoperative situations: of 104 patients, 67 underwent enucleation of hepatic hemangioma, 37 underwent hepatectomy. The tumor diameter, volume of intraoperative blood loss, duration of postoperative hospital stay were (10±4)cm, 200 mL (range, 10-3 000 mL), (11±5)days. Seven patients had complications, including 5 of massive abdominal ascites, 1 of abdominal infection, and 1 of pulmanory obstruction. There was no death occurred. (2) Assessment of quality of life in patients with hepatic hemangioma: the total scores of Gastrointestinalrelated Quality of Life Index (GIQLI), the scores of subjective symptoms, physiological status, mental and psychological status, and social activities were 121.0±8.3, 69.2±4.1, 18.5±2.6, 19.5±1.8, and 13.8±1.4 at preoperation. The above indices were 121.9±6.9, 71.2±3.8, 17.2±2.5, 19.6±2.3, and 13.8±1.3 of 104 patients with hepatic hemangioma at one month after surgery, respectively. The above indices were 127.8±6.2, 73.2±3.6, 19.8±2.5, 20.8±2.4, and 14.1±1.0 at 6 months after surgery. There were significant differences in changing trends of above indices (F=68.4, 64.6, 71.4, 17.8, 3.3, P<0.05). The scores of subjective symptoms and physiological status at one month after surgery showed significant differences compared with those of preoperation (t=-5.780, 6.640, P<0.05), but the total scores of GIQLI, the scores of mental and psychological status, and social activities showed no difference (t=-1.569,-0.705, 0.240, P>0.05). The total scores of GIQLI, scores of subjective symptoms, physiological status, and mental and psychological status at 6 months after surgery showed significant differences compared with those of preoperation (t=-8.897,-9.919,-5.375,-5.024, P<0.05), but the score of social activities showed no difference(t=-1.919, P>0.05). The total scores of GIQLI, the scores of subjective symptoms, physiological status, mental and psychological status, and social activities at 6 months after surgery were significantly different from those at one month after surgery (t=-10.835,-6.787,-12.277,-4.560, -2.476, P<0.05). (3) Assessment of quality of life in hepatic hemangioma patients comorbid with other chronic digestive diseases: 29 of 104 patients were comorbid with chronic gastritis, biliary diseases, and appendicitis. For the 29 patients comorbid with other chronic digestive diseases, the total scores of GIQLI, the scores of subjective symptoms, physiological status,mental and psychological status, and social activities were 117.5±7.5, 67.8±4.2, 17.4±2.2, 19.0±1.5, and 13.2±1.3 at preoperation. The above indices were 118.7±6.9, 69.5±4.5, 16.7±2.0, 19.2±1.9, and 13.2±1.3 at one month after surgery, respectively. The above indices were 124.6±6.5, 70.9±4.5, 19.8±2.1, 19.9±2.4, and 14.0±0.9 of 29 patients comorbid with other chronic digestive diseases at 6 months after surgery. There were significant differences in changing of the total scores of GIQLI, the scores of subjective symptoms, physiological status, and social activities (F=15.0, 9.0, 27.6, 7.5, P<0.05), except the score of mental and psychological status (F=1.6, P>0.05) . The scores of subjective symptoms and physiological status at one month after surgery showed significant differences compared with those of preoperation (t=-2.612, 2.191, P<0.05), but the total scores of GIQLI, the scores of mental and psychological status, and social activities showed no difference (t=-1.128,-0.587,-0.157, P>0.05). The total scores of GIQLI, scores of subjective symptoms, physiological status, and social activities at 6 months after surgery showed significant differences compared with those of preoperation (t=-4.002,-3.441,-4.604,-3.266, P<0.05), but the score of mental and psychologica status showed no difference (t=-1.522, P>0.05). The total scores of GIQLI, the scores of subjective symptoms, physiological status, and social activities at 6 months after surgery were significantly different from those at one month after surgery (t=-4.819,-2.313,-7.081,-3.172, P<0.05), but the score of mental and psychological status had no significant difference (t=-1.154, P>0.05).
Conclusions:The quality of life in patients with hepatic hemangioma can be improved by surgery. Surgical treatment is still effective for improvement of the total scores of GIQLI, the scores of subjective symptoms, physiological status, and social activities for those combined with other digestive diseases.