肝血管瘤外科手术时机和适应证选择再认识OA

Hepatic hemangioma is the most common benign liver tumor and is often detected during routine physical examination.Most lesions grow slowly,whereas a minority may enlarge progressively to giant hemangioma and cause symptoms such as abdominal distension and poor appetite.To date,high-level evidence-based guidelines are still lacking,leading to substantial inter-center variation in surgical indications.With advances in minimally invasive surgery,intraoperative visualization,and artificial intelligence-assisted decision-making,diagnostic accuracy has improved and perioperative trauma and risk have declined,which has intensified the debate on optimal timing and indications for surgery.The key controversy is whether to intervene earlier at a relatively low procedural cost to eliminate potential growth risk,or to prioritize close surveillance and operate after symptom development to avoid overtreatment.Current evidence and clinical experience support an individualized strategy based on symptoms,growth dynamics,anatomical location,technical feasibility,and expected benefit-risk balance,with dynamic reassessment over time.In the context of precision liver resection and minimally invasive surgery,a more practical risk-stratified indication framework is needed to optimize surgical timing and overall outcomes.