Monosegment 4±1 Associating Liver Partition and Portal Vein ligation for Staged hepatectomy(ALPPS)for bilateral colorectal liver metastases decreases the risk of drop-out of two stage hepatectomy,triggering a rap...Monosegment 4±1 Associating Liver Partition and Portal Vein ligation for Staged hepatectomy(ALPPS)for bilateral colorectal liver metastases decreases the risk of drop-out of two stage hepatectomy,triggering a rapid and significant increase in future liver remnant(FLR)with promising oncological outcomes.We report two cases of segment 4+1 monosegment ALPPS for multiple colorectal liver metastases performed at our institution.In the literature,seven similar cases have been reported.Short and long term outcomes of our two patients were reported along with a review of data from the literature.Our patients showed a FLR increase from 13%to 37%and from 14%to 41%of total liver volume,respectively.This was compared to a median growth from 19%at baseline to 34%before stage 2,in the literature.After 20 and 27 months since resection both patients are alive and disease-free.In the literature,median overall survival and disease free survival were 13 months(range,5–24 months)and 5 months(range,3–23 months),respectively.Segment 4±1 ALPPS is associated with promising oncological outcomes and a significant FLR growth.It may be safely performed in selected patients as a salvage procedure,reducing the risk of the dropout of two-stage hepatectomy.展开更多
文摘Monosegment 4±1 Associating Liver Partition and Portal Vein ligation for Staged hepatectomy(ALPPS)for bilateral colorectal liver metastases decreases the risk of drop-out of two stage hepatectomy,triggering a rapid and significant increase in future liver remnant(FLR)with promising oncological outcomes.We report two cases of segment 4+1 monosegment ALPPS for multiple colorectal liver metastases performed at our institution.In the literature,seven similar cases have been reported.Short and long term outcomes of our two patients were reported along with a review of data from the literature.Our patients showed a FLR increase from 13%to 37%and from 14%to 41%of total liver volume,respectively.This was compared to a median growth from 19%at baseline to 34%before stage 2,in the literature.After 20 and 27 months since resection both patients are alive and disease-free.In the literature,median overall survival and disease free survival were 13 months(range,5–24 months)and 5 months(range,3–23 months),respectively.Segment 4±1 ALPPS is associated with promising oncological outcomes and a significant FLR growth.It may be safely performed in selected patients as a salvage procedure,reducing the risk of the dropout of two-stage hepatectomy.
