Department of General, Visceral, and Transplantation Surgery, Ruprecht Karl University, Heidelberg, Germany.
Department of General, Visceral, and Transplantation Surgery, Ruprecht Karl University, Heidelberg, Germany; Study Center of the German Surgical Society (SDGC), Heidelberg University Hospital, Heidelberg, Germany.
HPB (Oxford). 2022 Mar;24(3):353-358. doi: 10.1016/j.hpb.2021.06.427. Epub 2021 Jul 6.
Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) has expanded and spearheaded development in hepatobiliary surgery. Monosegment-ALPPS tests liver regeneration limits and may present as the last feasible curative treatment option.
Electronic databases (MEDLINE, Web of Science, Google Scholar, Cochrane Library and WHO International Clinical Trials Registry Platform) were searched for publications on mono-ALPPS using a predefined strategy without date or language restrictions. Individual patient data was extracted and analyzed.
237 publications were identified. 19 patients were identified to have undergone mono-ALPPS. Primarily, mono-ALPPS has been utilized as curative treatment for CRLM (17 of 19 cases). Successful mono-ALPPS was possible in FLR above 8% SLV. All patients received either chemotherapy alone or in combination with radiotherapy prior to surgery. 8 of 19 patients experienced PHLF grade A or B. There was no in-hospital mortality described. Recurrent disease has occurred in 7 of 19 patients and 3 have died during follow-up.
Mono-ALPPS is an experimental procedure that provides a reasonably safe opportunity to curatively treat extensive liver malignancies in patients with FLR as low as 8% SLV. PHLF is the most prevalent complication in mono-ALPPS. Mono-ALPPS should be evaluated in a multicentral study setting.
联合肝脏离断和门静脉结扎的分阶段肝切除术（ALPPS）拓宽并引领了肝胆外科学的发展。单节段 ALPPS 测试了肝脏再生的极限，可能成为最后可行的治愈性治疗选择。
使用预定义策略，无日期或语言限制，在电子数据库（MEDLINE、Web of Science、Google Scholar、Cochrane 图书馆和世界卫生组织国际临床试验注册平台）中搜索关于单节段 ALPPS 的出版物。提取和分析个体患者数据。
确定了 237 篇出版物。19 名患者被确定接受了单节段 ALPPS 治疗。主要将单节段 ALPPS 用作 CRLM 的治愈性治疗（19 例中的 17 例）。在 SLV 以上 8%的 FLR 中，成功实施单节段 ALPPS。所有患者在手术前均接受了单独化疗或联合放化疗。19 例中有 8 例发生了 A 或 B 级 PHLF。无院内死亡报道。19 例中有 7 例出现复发性疾病，3 例在随访期间死亡。
单节段 ALPPS 是一种实验性手术，为 FLR 低至 8%SLV 的患者提供了合理安全的治愈性治疗广泛肝恶性肿瘤的机会。PHLF 是单节段 ALPPS 中最常见的并发症。应在多中心研究环境中评估单节段 ALPPS。
