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Monosegment ALPPS hepatectomy: extending resectability by rapid hypertrophy

Standard

Monosegment ALPPS hepatectomy: extending resectability by rapid hypertrophy. / Schadde, Erik; Malagó, Massimo; Hernandez-Alejandro, Roberto; Li, Jun; Abdalla, Eddie; Ardiles, Victoria; Lurje, Georg; Vyas, Soumil; Machado, Marcel A; de Santibañes, Eduardo.

in: SURGERY, Jahrgang 157, Nr. 4, 04.2015, S. 676-89.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Schadde, E, Malagó, M, Hernandez-Alejandro, R, Li, J, Abdalla, E, Ardiles, V, Lurje, G, Vyas, S, Machado, MA & de Santibañes, E 2015, 'Monosegment ALPPS hepatectomy: extending resectability by rapid hypertrophy', SURGERY, Jg. 157, Nr. 4, S. 676-89. https://doi.org/10.1016/j.surg.2014.11.015

APA

Schadde, E., Malagó, M., Hernandez-Alejandro, R., Li, J., Abdalla, E., Ardiles, V., Lurje, G., Vyas, S., Machado, M. A., & de Santibañes, E. (2015). Monosegment ALPPS hepatectomy: extending resectability by rapid hypertrophy. SURGERY, 157(4), 676-89. https://doi.org/10.1016/j.surg.2014.11.015

Vancouver

Schadde E, Malagó M, Hernandez-Alejandro R, Li J, Abdalla E, Ardiles V et al. Monosegment ALPPS hepatectomy: extending resectability by rapid hypertrophy. SURGERY. 2015 Apr;157(4):676-89. https://doi.org/10.1016/j.surg.2014.11.015

Bibtex

@article{dab33b2361074f55bc23ddd0da5670e8,
title = "Monosegment ALPPS hepatectomy: extending resectability by rapid hypertrophy",
abstract = "BACKGROUND: Liver remnant function limits major liver resections to generally leave patients with ≥2 Couinaud segments. Associating Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS) induces extensive hypertrophy and allows surgeons to perform extreme liver resections.METHODS: The international ALPPS registry (NCT01924741; 2011-2014) was screened for novel resection type with only 1 segment remnant. The anatomy of lesions and indications for ALPPS, operative technique, complications, survival, and recurrence were evaluated.RESULTS: Among 333 patients, 12 underwent monosegment ALPPS hepatectomies in 6 centers, all for extensive bilobar colorectal liver metastases. All patients were considered unresectable by conventional means, and all had a response to or no progression after chemotherapy before surgery. In 2 patients, the liver remnant consisted of segment 2, in 2 of segment 3, in 6 of segment 4, and in 2 of segment 6. Median time to proceed to stage 2 was 13 days and median hypertrophy of the liver remnant was 160%. There was no mortality. Four patients experienced liver failure, but all recovered. Complications higher than Dindo-Clavien IIIa occurred in 4 patients with no long-term sequelae. At a median follow-up of 14 months, 6 patients are tumor free and 6 patients have developed recurrent metastatic disease.CONCLUSION: ALPPS allows systematic liver resections with monosegment remnants, a novelty in liver surgery. Because such resections are difficult to conceive without rapid hypertrophy, we propose to name such resections after the segments constituting the liver remnant rather than the segments removed.",
keywords = "Adult, Aged, Colorectal Neoplasms, Feasibility Studies, Female, Follow-Up Studies, Hepatectomy, Humans, Hypertrophy, Ligation, Liver, Liver Failure, Liver Neoplasms, Male, Middle Aged, Portal Vein, Postoperative Complications, Registries, Retrospective Studies, Treatment Outcome, Evaluation Studies, Journal Article, Research Support, Non-U.S. Gov't",
author = "Erik Schadde and Massimo Malag{\'o} and Roberto Hernandez-Alejandro and Jun Li and Eddie Abdalla and Victoria Ardiles and Georg Lurje and Soumil Vyas and Machado, {Marcel A} and {de Santiba{\~n}es}, Eduardo",
note = "Copyright {\textcopyright} 2015 Elsevier Inc. All rights reserved.",
year = "2015",
month = apr,
doi = "10.1016/j.surg.2014.11.015",
language = "English",
volume = "157",
pages = "676--89",
journal = "SURGERY",
issn = "0039-6060",
publisher = "Mosby Inc.",
number = "4",

}

RIS

TY - JOUR

T1 - Monosegment ALPPS hepatectomy: extending resectability by rapid hypertrophy

AU - Schadde, Erik

AU - Malagó, Massimo

AU - Hernandez-Alejandro, Roberto

AU - Li, Jun

AU - Abdalla, Eddie

AU - Ardiles, Victoria

AU - Lurje, Georg

AU - Vyas, Soumil

AU - Machado, Marcel A

AU - de Santibañes, Eduardo

N1 - Copyright © 2015 Elsevier Inc. All rights reserved.

PY - 2015/4

Y1 - 2015/4

N2 - BACKGROUND: Liver remnant function limits major liver resections to generally leave patients with ≥2 Couinaud segments. Associating Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS) induces extensive hypertrophy and allows surgeons to perform extreme liver resections.METHODS: The international ALPPS registry (NCT01924741; 2011-2014) was screened for novel resection type with only 1 segment remnant. The anatomy of lesions and indications for ALPPS, operative technique, complications, survival, and recurrence were evaluated.RESULTS: Among 333 patients, 12 underwent monosegment ALPPS hepatectomies in 6 centers, all for extensive bilobar colorectal liver metastases. All patients were considered unresectable by conventional means, and all had a response to or no progression after chemotherapy before surgery. In 2 patients, the liver remnant consisted of segment 2, in 2 of segment 3, in 6 of segment 4, and in 2 of segment 6. Median time to proceed to stage 2 was 13 days and median hypertrophy of the liver remnant was 160%. There was no mortality. Four patients experienced liver failure, but all recovered. Complications higher than Dindo-Clavien IIIa occurred in 4 patients with no long-term sequelae. At a median follow-up of 14 months, 6 patients are tumor free and 6 patients have developed recurrent metastatic disease.CONCLUSION: ALPPS allows systematic liver resections with monosegment remnants, a novelty in liver surgery. Because such resections are difficult to conceive without rapid hypertrophy, we propose to name such resections after the segments constituting the liver remnant rather than the segments removed.

AB - BACKGROUND: Liver remnant function limits major liver resections to generally leave patients with ≥2 Couinaud segments. Associating Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS) induces extensive hypertrophy and allows surgeons to perform extreme liver resections.METHODS: The international ALPPS registry (NCT01924741; 2011-2014) was screened for novel resection type with only 1 segment remnant. The anatomy of lesions and indications for ALPPS, operative technique, complications, survival, and recurrence were evaluated.RESULTS: Among 333 patients, 12 underwent monosegment ALPPS hepatectomies in 6 centers, all for extensive bilobar colorectal liver metastases. All patients were considered unresectable by conventional means, and all had a response to or no progression after chemotherapy before surgery. In 2 patients, the liver remnant consisted of segment 2, in 2 of segment 3, in 6 of segment 4, and in 2 of segment 6. Median time to proceed to stage 2 was 13 days and median hypertrophy of the liver remnant was 160%. There was no mortality. Four patients experienced liver failure, but all recovered. Complications higher than Dindo-Clavien IIIa occurred in 4 patients with no long-term sequelae. At a median follow-up of 14 months, 6 patients are tumor free and 6 patients have developed recurrent metastatic disease.CONCLUSION: ALPPS allows systematic liver resections with monosegment remnants, a novelty in liver surgery. Because such resections are difficult to conceive without rapid hypertrophy, we propose to name such resections after the segments constituting the liver remnant rather than the segments removed.

KW - Adult

KW - Aged

KW - Colorectal Neoplasms

KW - Feasibility Studies

KW - Female

KW - Follow-Up Studies

KW - Hepatectomy

KW - Humans

KW - Hypertrophy

KW - Ligation

KW - Liver

KW - Liver Failure

KW - Liver Neoplasms

KW - Male

KW - Middle Aged

KW - Portal Vein

KW - Postoperative Complications

KW - Registries

KW - Retrospective Studies

KW - Treatment Outcome

KW - Evaluation Studies

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

U2 - 10.1016/j.surg.2014.11.015

DO - 10.1016/j.surg.2014.11.015

M3 - SCORING: Journal article

C2 - 25712199

VL - 157

SP - 676

EP - 689

JO - SURGERY

JF - SURGERY

SN - 0039-6060

IS - 4

ER -