A new strategy in the surgical treatment of multiple liver tumors – ALPPS
Authors:
M. Peteja 1,2,3; L. Martínek 2,3; M. Mazur 2,3; P. Vávra 2,3; P. Zonča 2,3; V. Janout 1
Authors‘ workplace:
Ústav epidemiologie a ochrany veřejného zdraví, Lékařská fakulta Ostravské univerzity v Ostravě
vedoucí ústavu: Prof. MUDr. V. Janout, CSc.
1; Chirurgická klinika, FN Ostrava, přednosta: Doc. MUDr. P. Zonča, Ph. D., FRCS
2; Katedra chirurgických oborů, Lékařská fakulta Ostravské univerzity v Ostravě
vedoucí katedry: Doc. MUDr. P. Zonča, Ph. D., FRCS
3
Published in:
Rozhl. Chir., 2014, roč. 93, č. 6, s. 301-306.
Category:
Review
Overview
Introduction:
This systematic review was performed to introduce the two-staged hepatectomy procedure (Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy - ALPPS) and present its current results.
Material and methods:
We conducted a systematic literature search using the PubMed database with key words “ALPPS” or “staged liver resection”. The inclusion criteria were randomized trials or cohort studies. Case reports were excluded. The primary end-point was the assessment of liver tissue hypertrophy after the ALPPS procedure. Morbidity and mortality evaluation were the secondary end-point.
Results:
After an electronic data search of PubMed with the selected key words, six cohort studies evaluating 96 patients met the inclusion criteria. There was no prospective randomised trial. Based on the results of the individual studies, liver hypertrophy ranged from 74 to 87%. Morbidity and mortality ranged from 53 to 71% and 0 to 13% respectively.
Conlcusions:
Despite the higher morbidity and mortality the ALPPS procedure could be a promising technique for a selected group of patients with multiple liver tumors. However long term results are not yet available.
Key words:
ALPPS – liver hypertrophy – portal vein ligation- liver resection – multiple liver metastases
Sources
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Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
2014 Issue 6
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