PDF(Pubmed)
Abstract：
UNASSIGNED: Recently, the ALPPS (Associating liver partition and portal vein ligation for staged hepatectomy) has become widely known to achieve hepatic resection by rapid future liver remnant hypertrophy, but it comes with intraoperative difficulties, followed by increased complications. This study aimed to report the outcomes of an oncology center in a low-income and middle-income country with ALPPS in patients with liver tumors and its technical variants, which were invented to overcome intraoperative difficulties of the ALPPS procedure.
UNASSIGNED: A retrospective analysis of patients undergoing ALPPS from September 2022 to December 2023 was performed.
UNASSIGNED: A total of 25 patients underwent the ALPPS procedure: 21 procedures for hepatocellular carcinoma (HCC), 3 combined hepatocellular-cholangiocarcinoma (cHCC-CCA), and 1 for small cell neuroendocrine carcinoma (SNEC). The mean postoperative stay was 29.6 ± 9.3 days (range 16-58 days). After stage 1, we counted 8 complications, all of grade II; after stage 2, the number of complications was decreased to 3:2 were of grade I and 1 were of grade IIIB. 3 (12%) patients failed to proceed to ALPPS stage 2. After a median follow-up of 9 months (range 2-25), disease recurrence has been recorded in 3 patients (12%), while 1 patient (4%) died, affected by HCC. The entire group\'s 2-year overall survival (OS) and disease-free survival (DFS) were 83.3% and 82.5%, respectively.
UNASSIGNED: The ALPPS procedure is an approach for large liver tumors with small future liver remnant with acceptable OS and DFS in a low-income and middle-income country.
UNASSIGNED: A retrospective analysis of patients undergoing ALPPS from September 2022 to December 2023 was performed.
UNASSIGNED: A total of 25 patients underwent the ALPPS procedure: 21 procedures for hepatocellular carcinoma (HCC), 3 combined hepatocellular-cholangiocarcinoma (cHCC-CCA), and 1 for small cell neuroendocrine carcinoma (SNEC). The mean postoperative stay was 29.6 ± 9.3 days (range 16-58 days). After stage 1, we counted 8 complications, all of grade II; after stage 2, the number of complications was decreased to 3:2 were of grade I and 1 were of grade IIIB. 3 (12%) patients failed to proceed to ALPPS stage 2. After a median follow-up of 9 months (range 2-25), disease recurrence has been recorded in 3 patients (12%), while 1 patient (4%) died, affected by HCC. The entire group\'s 2-year overall survival (OS) and disease-free survival (DFS) were 83.3% and 82.5%, respectively.
UNASSIGNED: The ALPPS procedure is an approach for large liver tumors with small future liver remnant with acceptable OS and DFS in a low-income and middle-income country.
摘要：
■最近，ALPPS（联合肝分区和门静脉结扎分期肝切除术）已成为广泛已知的实现肝切除的快速未来的肝残余肥大，但是它伴随着术中的困难，并发症增加。这项研究旨在报告低收入和中等收入国家的肿瘤中心在患有ALPPS的肝肿瘤患者及其技术变体中的结果。这些发明是为了克服ALPPS手术的术中困难。
■对2022年9月至2023年12月接受ALPPS的患者进行了回顾性分析。
■共有25例患者接受了ALPPS手术：21例肝细胞癌（HCC）手术，3联合肝细胞胆管癌（cHCC-CCA），1为小细胞神经内分泌癌（SNEC）。术后平均住院时间为29.6±9.3天（范围16-58天）。在第1阶段之后，我们计算了8个并发症，全部为II级；在第2阶段后，并发症的数量减少到3:2为I级，1为IIIB级。3例(12%)患者未能进入ALPPS2期。经过9个月的中位随访（范围2-25），已记录3例患者（12％）的疾病复发，1名患者（4%）死亡，受HCC影响。全组2年总生存率(OS)和无病生存率(DFS)分别为83.3%和82.5%,分别。
■ALPPS程序是一种在低收入和中等收入国家中具有可接受的OS和DFS的未来肝脏残留小的大型肝脏肿瘤的方法。
■对2022年9月至2023年12月接受ALPPS的患者进行了回顾性分析。
■共有25例患者接受了ALPPS手术：21例肝细胞癌（HCC）手术，3联合肝细胞胆管癌（cHCC-CCA），1为小细胞神经内分泌癌（SNEC）。术后平均住院时间为29.6±9.3天（范围16-58天）。在第1阶段之后，我们计算了8个并发症，全部为II级；在第2阶段后，并发症的数量减少到3:2为I级，1为IIIB级。3例(12%)患者未能进入ALPPS2期。经过9个月的中位随访（范围2-25），已记录3例患者（12％）的疾病复发，1名患者（4%）死亡，受HCC影响。全组2年总生存率(OS)和无病生存率(DFS)分别为83.3%和82.5%,分别。
■ALPPS程序是一种在低收入和中等收入国家中具有可接受的OS和DFS的未来肝脏残留小的大型肝脏肿瘤的方法。
