Manuscript title: The surgical outcomes and risk factors of giant hepatic haemangiomas: A single centre experience

Abstract Objective: To evaluate the safety of performing surgery on cavernous haemangiomas in the liver larger than 10 cm and establish preoperative predictors of intraoperative blood transfusion and morbidity.Methods: A total of 373 patients with haemangiomas larger than 10 cm who underwent surgery in our hospital were retrospectively analysed. According to tumour diameter, the patients were divided into a giant haemangioma (GH) group (241 cases) (10 cm ≤diameter <15 cm) and an enormous haemangioma (EH) group (132 cases) (diameter ≥15 cm). Clinical parameters were then compared between the two groups.Results: Compared with the GH group, the EH group had higher rates of leukopenia (10.6% vs. 4.5%), anaemia (26.5% vs. 15.7%), and thrombocytopenia (13.6% vs. 6.2%). The occlusion time in the EH group was longer than that in the GH group (26.33±14.10 min vs. 31.85±20.09 min, P<0.01). The blood loss and blood transfusion in the EH group were greater than those in the GH group (P<0.05). Moreover, the morbidity in the EH group was higher than that in the GH group (17.4% vs. 9.13%, P<0.05). According to the results of the multivariable analysis, the operation time and size of the haemangioma may be independent risk factors for blood transfusion (P<0.05). Additionally, the size of the haemangioma may be an independent risk factor associated with complications (P<0.05).Conclusion: Enormous haemangioma is more likely to cause haematologic abnormalities than giant hepatic haemangioma. The risks of the operation and postoperative complications of enormous haemangioma are higher than those of giant hepatic haemangioma.