Pushing the limit of liver regeneration - safety and survival after monosegment-ALPPS: systematic review and individual patient data meta-analysis
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...
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| Hauptverfasser: | , , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
2022
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| In: |
HPB
Year: 2022, Jahrgang: 24, Heft: 3, Pages: 353-358 |
| ISSN: | 1477-2574 |
| DOI: | 10.1016/j.hpb.2021.06.427 |
| Online-Zugang: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.hpb.2021.06.427 Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S1365182X21006092 
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| Verfasserangaben: | Anastasia Murtha-Lemekhova, Juri Fuchs, Erik Schulz, Anthe Sterkenburg, Pascal Probst & Katrin Hoffmann |
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| 245 | 1 | 0 | |a Pushing the limit of liver regeneration - safety and survival after monosegment-ALPPS |b systematic review and individual patient data meta-analysis |c Anastasia Murtha-Lemekhova, Juri Fuchs, Erik Schulz, Anthe Sterkenburg, Pascal Probst & Katrin Hoffmann |
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| 520 | |a 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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