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Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS): Short-term outcome, functional changes in the future liver remnant, and tumor growth activity
- Source :
- European Journal of Surgical Oncology (EJSO). 41:506-512
- Publication Year :
- 2015
- Publisher :
- Elsevier BV, 2015.
-
Abstract
- Background We compared clinical outcomes of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) against those of classical 2-stage hepatectomy in treating metastatic liver disease. Methods Short-term outcomes, serial changes in volume of the future liver remnant (FLR), functional FLR volume, and tumor growth activity during the treatment period, were compared between our first 11 consecutive patients treated with ALPPS and 54 patients treated with classical 2-stage hepatectomy. Results Mortality in the ALPPS group (9%) tended to be higher than in the classical 2-stage group (2%, P = 0.341). The FLR hypertrophy ratio (FLR volume after vs. before the procedure) 1 week after the first operation in the ALPPS group (1.54 ± 0.18) exceeded that in the classical 2-stage group (1.19 ± 0.29, P = 0.005), being similar to the ratio at 3 weeks after the first procedure in the classical 2-stage group (1.40 ± 0.43). However, functional volume of the FLR in the ALPPS group 1 week after the first procedure (52.1%) tended to be smaller than that in the classical group 3 weeks after the first procedure (59.2%). Conclusions ALPPS should be used with extreme caution, giving special attention to postoperative complications and grade of functional liver regeneration.
- Subjects :
- Adult
Male
medicine.medical_specialty
Colorectal cancer
medicine.medical_treatment
Muscle hypertrophy
Carcinoembryonic antigen
Hepatectomy
Humans
Medicine
Tumor growth
Ligation
Aged
biology
Portal Vein
business.industry
Liver Neoplasms
Metastatic liver disease
Hypertrophy
Organ Size
Recovery of Function
General Medicine
Middle Aged
medicine.disease
Liver regeneration
Liver Regeneration
Tumor Burden
Surgery
Ki-67 Antigen
Liver
Oncology
Disease Progression
biology.protein
Female
medicine.symptom
business
Subjects
Details
- ISSN :
- 07487983
- Volume :
- 41
- Database :
- OpenAIRE
- Journal :
- European Journal of Surgical Oncology (EJSO)
- Accession number :
- edsair.doi.dedup.....33eb2a9e94712e703334c8b82e8b156a