Local Ablation Versus Surgical Resection for Liver Hemangioma: a Systematic Review and Meta-analysis

Surgical resection (SR) is the standard treatment for liver hemangioma (LH). Local ablation (LA) is a promising alternative treatment. This meta-analysis was conducted to compare the effectiveness and safety of LA in LH treatment. Clinical studies were retrieved from PubMed, Embase, Cochrane Library, Medline, and Web of Science electronic databases. Study-specific effect sizes and their 95% confidence intervals (CI) were combined to calculate the pooled value, using a fixed-effects or random effect model. Five studies were included. Major operation time (mean difference [MD] = - 121.17; 95% CI = - 155.38 - - 86.97), blood loss (MD = - 257.11; 95% CI = - 312.65 - - 201.58), hospital stay (MD = - 2.83; 95% CI = - 4.71 - - 0.94), and postoperative pain score after 12 h (MD = - 1.77; 95% CI = - 2.15 - - 1.39), 24 h (MD = -0.93; 95% CI = - 1.22 - - 0.65), and 48 h (MD = - 0.64; 95% CI = - 0.95 - - 0.33) were all lower in the LA group compared with the SR group. However, higher ALT (MD = 75.62; 95% CI = 23.99-127.25) and AST (MD = 129.92; 95% CI = 44.56-215.29) values were found in the LA group 1 day after the surgery. This systematic review shows the superiority of LA over SR in terms of effectiveness and safety in LH treatment.