Monosegmental ALPPS after Bilateral Hepatectomy

Steinbrück, Klaus; D'Oliveira, Marcelo Silveira; Cano, Renato; Enne, Marcelo

doi:10.5604/01.3001.0010.2825

Cited by 7 publications

(6 citation statements)

References 8 publications

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“…Many other technical ALPPS modifications have been named according to the liver segment(s) that will form the future liver remnant [ 23 , 24 ]. Only one segment includes FLR in mono-segmental ALPPS [ 25 , 26 ]. “Rescue ALPPS” relates to the procedure of ALPPS carried out in subjects who have not achieved an adequate FLR after PVE to undergo TSH in the second step [ 27 - 30 ].…”

Section: Original Alpps Surgical Technique and Modifications Adoptedmentioning

confidence: 99%

Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in colorectal liver metastases: review of the literature

Coco¹,

Leanza²

2021

ceh

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Section: Original Alpps Surgical Technique and Modifications Adoptedmentioning

confidence: 99%

Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in colorectal liver metastases: review of the literature

Coco¹,

Leanza²

2021

ceh

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“…Seven publication reporting on 19 patients were included in the final analysis. 4,[13][14][15][16][17][18] Utilized data is presented in Supplementary Table 2.…”

Section: Resultsmentioning

confidence: 99%

Pushing the limit of liver regeneration – Safety and survival after monosegment-ALPPS: systematic review and individual patient data meta-analysis

Murtha-Lemekhova

Fuchs

Schulz

et al. 2022

HPB

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Background: Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has expanded and spearheaded development in hepatobiliary surgery. Monosegment-ALPPS tests liver regeneration limits and may present as the last feasible curative treatment option.Methods: Electronic databases (MEDLINE, Web of Science, Google Scholar, Cochrane Library and WHO International Clinical Trials Registry Platform) were searched for publications on mono-ALPPS using a predefined strategy without date or language restrictions. Individual patient data was extracted and analyzed.Results: 237 publications were identified. 19 patients were identified to have undergone mono-ALPPS.Primarily, mono-ALPPS has been utilized as curative treatment for CRLM (17 of 19 cases). Successful mono-ALPPS was possible in FLR above 8% SLV. All patients received either chemotherapy alone or in combination with radiotherapy prior to surgery. 8 of 19 patients experienced PHLF grade A or B. There was no in-hospital mortality described. Recurrent disease has occurred in 7 of 19 patients and 3 have died during follow-up. Conclusion:Mono-ALPPS is an experimental procedure that provides a reasonably safe opportunity to curatively treat extensive liver malignancies in patients with FLR as low as 8% SLV. PHLF is the most prevalent complication in mono-ALPPS. Mono-ALPPS should be evaluated in a multicentral study setting.

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“…Al respecto, existe importante escasez de evidencia en la literatura respecto al uso del ALPPS monosegmento y sus resultados clínicos, sin embargo, la serie más importante corresponde a la publicada por Schadde a partir del registro internacional de ALPPS 20 . En este trabajo, se presentan los resultados de 12 pacientes sometidos a ALPPS monosegmento por metástasis hepáticas de cáncer colorrectal, destacando una relación peso remanente/ peso corporal total pre ALPPS de 0,33 (0,18-0,48), alcanzando un aumento volumétrico de 160% (93-250%) post ALPPS, siendo resecados en un periodo de 13 días 6,20,21 . Tales cifras se corresponden con otros reportes de series de casos similares 15,21,22 (Tabla 2).…”

Section: Discussionunclassified

ALPPS monosegmento, una variante de hepatectomía extrema para resección de metástasis hepáticas de cáncer colorrectal

2022

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La resección quirúrgica con márgenes negativos de las metástasis hepáticas de cáncer colorrectal, representa la única opción de tratamiento con potencial curativo, sin embargo, el 85% de estos pacientes son considerados irresecables a la evaluación inicial, ya sea por número, tamaño y localización de las metástasis o por un remanente hepático futuro insuficiente. ALPPS es una técnica quirúrgica compleja, que permite en dos tiempos operatorios, la resección de extensas porciones de parénquima hepático tras un periodo de incremento volumétrico del remanente, que alcanza el 80% en un periodo de 9 días, lo que supera ampliamente a otras técnicas como la embolización/ligadura portal preoperatoria. Pese a cuestionamientos iniciales relativos a la morbimortalidad asociada, la significativa ganancia de masa hepatocelular lograda con ALPPS, ha permitido el tratamiento exitoso de pacientes con alta carga tumoral metastásica hepática, tensionando principios fundamentales clásicamente considerados para la realización de hepatectomías mayores en forma segura. El objetivo de este trabajo es presentar la experiencia inicial con la aplicación de la técnica de ALPPS llevado al extremo de dejar un remanente hepático constituido por un único segmento.

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Monosegmental ALPPS after Bilateral Hepatectomy

Cited by 7 publications

References 8 publications

Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in colorectal liver metastases: review of the literature

Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) in colorectal liver metastases: review of the literature

Pushing the limit of liver regeneration – Safety and survival after monosegment-ALPPS: systematic review and individual patient data meta-analysis

ALPPS monosegmento, una variante de hepatectomía extrema para resección de metástasis hepáticas de cáncer colorrectal

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