The cost-effect analysis of interventional and surgical therapy for symptomatic cavernous hemangioma of liver

Objective: Through comparing the damage of hepatic function, occurrence of complications, hospitalization days and medical expense between PLE-IASE therapy and surgical management for symptomatic cavernous hemangioma of liver to provide theoretical guidance in selecting proper treatment for this disease. Methods: One hundred and forty-seven patients were randomly divided into PLE-IASE embolization group (n=89) and surgery group (n=58). Before and 3-7 days after the treatment liver function, including ALT, AST, TBIL, IBIL, TP and ALB, was tested in all patients. The differences in the liver function data between two groups were statistically analyzed. The hospitalization days and medical expense of two groups were also recorded and compared. The complication occurrence of both short-term and long-term was observed, and the results in two groups were compared. Results: No significant difference in liver function was found between two groups before the treatment. After the treatment, the increase of ALT, AST and TBIL in embolization group was significantly lower than that in surgery group, with P value being 0.000, 0.014 and 0.004 respectively. The decrease of TP and ALB in embolization group was also lower than that in surgery group (both P=0.000). During hospitalization, complication occurred in one case in embolization group and in 12 cases in surgery group of which mild complication was seen in 10 and serious complication in 2. No treatment-related complications occurred in long-term observation in neither of the groups. The complication occurrence in embolization group and surgery group was 1.1% and 20.7% respectively, with a significant difference between two groups (P=0.000). The mean hospitalization days and medical expense in embolization group were (8.0 ± 3.5) days and (13 612.7 ± 5 860.5) respectively, while in surgery group were(19.0 ± 5.0) days and (26 335.6 ± 8 314.0) respectively, with significant difference (both P=0.000). Conclusion: For the treatment of symptomatic cavernous hemangioma of the liver, PLE- IASE therapy is superior to surgical procedure in its less damage to liver function, fewer complications, shorter time of hospitalization and less medical expense with high cost-effect ratio. (authors)