PDF(Pubmed)
Abstract：
UNASSIGNED: Colorectal liver metastases (CRLMs) represent the most prevalent form of secondary liver tumors, and insufficient future liver remnant (FLR) often leads to unresectability. To tackle this challenge, various methods for stimulating liver hypertrophy have been developed including portal vein embolization (PVE), associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) and the newest one, liver venous deprivation (LVD). ALPPS was thoroughly studied over the last decade and it has been shown to induce rapid and intensive FLR hypertrophy. The objective of this study was to assess whether the localization of the liver transection line during the initial stage of ALPPS correlates with the degree of FLR hypertrophy.
UNASSIGNED: A retrospective, multicentric study was conducted, and we analyzed all consecutive patients with CRLMs who underwent ALPPS over the eight-year period. Patients were categorized into two groups based on the type of resection-right trisectionectomy (ERH) or right hemihepatectomy (RH) respectively. The degree of hypertrophy (DH), its correlation with FLR and postoperative outcomes were assessed.
UNASSIGNED: The cohort consisted of 136 patients (72 in the ERH group and 64 in the RH group). Baseline characteristics, hypertrophy interval, and total liver volume showed no significant differences between the groups. DH was greater in the ERH group (83.2% vs. 62.5%, p = 0.025). A strong negative correlation was observed between FLR volume and DH in both groups. Postoperative outcomes and one-year survival were comparable between the groups.
UNASSIGNED: FLR hypertrophy is influenced by the localization of the liver transection line in ALPPS. Furthermore, correlation analysis indicated that a smaller estimated FLR is associated with greater DH. No statistical difference in outcomes was noted between the groups.
UNASSIGNED: A retrospective, multicentric study was conducted, and we analyzed all consecutive patients with CRLMs who underwent ALPPS over the eight-year period. Patients were categorized into two groups based on the type of resection-right trisectionectomy (ERH) or right hemihepatectomy (RH) respectively. The degree of hypertrophy (DH), its correlation with FLR and postoperative outcomes were assessed.
UNASSIGNED: The cohort consisted of 136 patients (72 in the ERH group and 64 in the RH group). Baseline characteristics, hypertrophy interval, and total liver volume showed no significant differences between the groups. DH was greater in the ERH group (83.2% vs. 62.5%, p = 0.025). A strong negative correlation was observed between FLR volume and DH in both groups. Postoperative outcomes and one-year survival were comparable between the groups.
UNASSIGNED: FLR hypertrophy is influenced by the localization of the liver transection line in ALPPS. Furthermore, correlation analysis indicated that a smaller estimated FLR is associated with greater DH. No statistical difference in outcomes was noted between the groups.
摘要：
■结直肠肝转移（CRLM）代表继发性肝肿瘤的最普遍形式，未来肝脏残存量（FLR）不足通常会导致无法切除。为了应对这一挑战，已经开发了各种刺激肝脏肥大的方法，包括门静脉栓塞（PVE），联合肝分区和门静脉结扎的分期肝切除术（ALPPS）和最新的，肝静脉剥夺（LVD）。在过去的十年中，ALPPS得到了彻底的研究，并且已经证明它可以诱导快速而强烈的FLR肥大。这项研究的目的是评估ALPPS初期肝脏横断线的定位是否与FLR肥大程度相关。
■回顾，进行了多中心研究，我们分析了所有连续8年接受ALPPS治疗的CRLM患者.根据切除类型将患者分为两组，分别为右三节切除术（ERH）或右半肝切除术（RH）。肥大程度（DH），评估其与FLR和术后结局的相关性.
■该队列包括136名患者（ERH组72名，RH组64名）。基线特征，肥大间隔，和总肝脏体积显示两组之间没有显着差异。DH在ERH组中更高（83.2%vs.62.5%,p=0.025)。在两组中，FLR体积与DH之间均呈强负相关。术后结局和一年生存率在两组之间具有可比性。
■FLR肥大受ALPPS中肝脏横切线定位的影响。此外，相关分析表明，较小的估计FLR与较大的DH相关。两组之间的结果无统计学差异。
■回顾，进行了多中心研究，我们分析了所有连续8年接受ALPPS治疗的CRLM患者.根据切除类型将患者分为两组，分别为右三节切除术（ERH）或右半肝切除术（RH）。肥大程度（DH），评估其与FLR和术后结局的相关性.
■该队列包括136名患者（ERH组72名，RH组64名）。基线特征，肥大间隔，和总肝脏体积显示两组之间没有显着差异。DH在ERH组中更高（83.2%vs.62.5%,p=0.025)。在两组中，FLR体积与DH之间均呈强负相关。术后结局和一年生存率在两组之间具有可比性。
■FLR肥大受ALPPS中肝脏横切线定位的影响。此外，相关分析表明，较小的估计FLR与较大的DH相关。两组之间的结果无统计学差异。
