PDF(Pubmed)
Abstract：
BACKGROUND: ALPPS leads to fast and effective liver hypertrophy. This enables the resection of extended tumors. Conventional ALPPS is associated with high morbidity and mortality. MILS reduces morbidity and the robot adds technical features that make complex procedures safe.
METHODS: The MD-MILS was screened for patients who underwent rALPPS. Demographic and perioperative data were evaluated retrospectively. Ninety days postoperative morbidity was scored according to the CD classification. The findings were compared with the literature.
RESULTS: Since November 2021, five patients have been identified. The mean age and BMI of the patients were 50.0 years and 22.7 kg/m2. In four cases, patients suffered from colorectal liver metastases and, in one case, intrahepatic cholangiocarcinoma. Prior to the first operation, the mean liver volume of the residual left liver was 380.9 mL with a FLR-BWR of 0.677%. Prior to the second operation, the mean volume of the residual liver was 529.8 mL with a FLR-BWR of 0.947%. This was an increase of 41.9% of the residual liver volume. The first and second operations were carried out within 17.8 days. The mean time of the first and second operations was 341.2 min and 440.6 min. The mean hospital stay was 27.2 days. Histopathology showed the largest tumor size of 39 mm in diameter with a mean amount of 4.7 tumors. The mean tumor-free margin was 12.3 mm. One complication CD > 3a occurred. No patient died during the 90-day follow up.
CONCLUSIONS: In the first German series, we demonstrated that rALPPS can be carried out safely with reduced morbidity and mortality in selected patients.
METHODS: The MD-MILS was screened for patients who underwent rALPPS. Demographic and perioperative data were evaluated retrospectively. Ninety days postoperative morbidity was scored according to the CD classification. The findings were compared with the literature.
RESULTS: Since November 2021, five patients have been identified. The mean age and BMI of the patients were 50.0 years and 22.7 kg/m2. In four cases, patients suffered from colorectal liver metastases and, in one case, intrahepatic cholangiocarcinoma. Prior to the first operation, the mean liver volume of the residual left liver was 380.9 mL with a FLR-BWR of 0.677%. Prior to the second operation, the mean volume of the residual liver was 529.8 mL with a FLR-BWR of 0.947%. This was an increase of 41.9% of the residual liver volume. The first and second operations were carried out within 17.8 days. The mean time of the first and second operations was 341.2 min and 440.6 min. The mean hospital stay was 27.2 days. Histopathology showed the largest tumor size of 39 mm in diameter with a mean amount of 4.7 tumors. The mean tumor-free margin was 12.3 mm. One complication CD > 3a occurred. No patient died during the 90-day follow up.
CONCLUSIONS: In the first German series, we demonstrated that rALPPS can be carried out safely with reduced morbidity and mortality in selected patients.
摘要：
背景：ALPPS导致快速有效的肝脏肥大。这使得能够切除扩展的肿瘤。常规ALPPS与高发病率和高死亡率相关。MILS降低发病率和机器人增加的技术特点，使复杂的程序安全。
方法：对接受rALPPS的患者进行MD-MILS筛查。回顾性评估人口统计学和围手术期数据。根据CD分类对术后90天的发病率进行评分。将研究结果与文献进行了比较。
结果：自2021年11月以来，已经确定了5名患者。患者的平均年龄和BMI为50.0岁和22.7kg/m2。在四个案例中，患有结直肠癌肝转移的患者，在一个案例中,肝内胆管癌。在第一次手术之前，剩余左肝的平均肝体积为380.9mL,FLR-BWR为0.677%.在第二次手术之前，残余肝脏的平均体积为529.8mL,FLR-BWR为0.947%.这是剩余肝脏体积的41.9%的增加。第一次和第二次手术在17.8天内进行。第一次和第二次手术的平均时间为341.2分钟和440.6分钟。平均住院时间为27.2天。组织病理学显示最大肿瘤直径为39mm,平均肿瘤量为4.7。平均无瘤边缘为12.3mm。发生一例并发症CD>3a。90天随访期间无患者死亡。
结论：在第一个德语系列中，我们证明rALPPS可以安全地进行,并且在部分患者中降低发病率和死亡率.
方法：对接受rALPPS的患者进行MD-MILS筛查。回顾性评估人口统计学和围手术期数据。根据CD分类对术后90天的发病率进行评分。将研究结果与文献进行了比较。
结果：自2021年11月以来，已经确定了5名患者。患者的平均年龄和BMI为50.0岁和22.7kg/m2。在四个案例中，患有结直肠癌肝转移的患者，在一个案例中,肝内胆管癌。在第一次手术之前，剩余左肝的平均肝体积为380.9mL,FLR-BWR为0.677%.在第二次手术之前，残余肝脏的平均体积为529.8mL,FLR-BWR为0.947%.这是剩余肝脏体积的41.9%的增加。第一次和第二次手术在17.8天内进行。第一次和第二次手术的平均时间为341.2分钟和440.6分钟。平均住院时间为27.2天。组织病理学显示最大肿瘤直径为39mm,平均肿瘤量为4.7。平均无瘤边缘为12.3mm。发生一例并发症CD>3a。90天随访期间无患者死亡。
结论：在第一个德语系列中，我们证明rALPPS可以安全地进行,并且在部分患者中降低发病率和死亡率.
