Pushing the limit of liver regeneration - safety and survival after monosegment-ALPPS

• Verfasst von: Murtha-Lemekhova, Anastasia [VerfasserIn]
• Verfasst von: Fuchs, Juri [VerfasserIn]
• Verfasst von: Schulz, Erik R. [VerfasserIn]
• Verfasst von: Sterkenburg, Anthe [VerfasserIn]
• Verfasst von: Probst, Pascal [VerfasserIn]
• Verfasst von: Hoffmann, Katrin [VerfasserIn]
• Titel: Pushing the limit of liver regeneration - safety and survival after monosegment-ALPPS
• Titelzusatz: systematic review and individual patient data meta-analysis
• Verf.angabe: Anastasia Murtha-Lemekhova, Juri Fuchs, Erik Schulz, Anthe Sterkenburg, Pascal Probst & Katrin Hoffmann
• Jahr: 2022
• Umfang: 6 S.
• Fussnoten: Available online 6 July 2021 ; Gesehen am 01.04.2022
• Titel Quelle: Enthalten in: HPB
• Ort Quelle: [London] : Elsevier, 1999
• Jahr Quelle: 2022
• Band/Heft Quelle: 24(2022), 3, Seite 353-358
• ISSN Quelle: 1477-2574
• DOI: doi:10.1016/j.hpb.2021.06.427
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1797305832

Abstract

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.