Minimally Invasive ALPPS Procedure: A Review of Feasibility and Short-Term Outcomes
Abstract
:Simple Summary
Abstract
1. Introduction
- Stage 1: portal vein ligation without dissection of the remaining structures of the pedicle combined with in situ splitting of the liver;
- Stage 2: completion of resection of the de-portalized liver via a right or extended right hepatectomy after an accelerated hypertrophy of portalized liver [3].
2. Materials and Methods
2.1. Search Strategy
2.2. Inclusion Criteria
2.3. Exclusion Criteria
2.4. Data Extraction and Outcomes
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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References | Age (Mean) | n | Type of Tumor (n) | FLRV/Body Weight Ratio Prior Stage 1 | |||
---|---|---|---|---|---|---|---|
CRLM | HCC | CCA | other | ||||
Gall et al. [16] | 62 | 5 | 5 | 0 | 0 | 0 | 0.5 |
Truant et al. [17] | 60.8 | 4 | 4 | 0 | 0 | 0 | 0.4 |
Jiao et al. [18] | 62.4 | 26 | 20 | 1 | 0 | 5 | 0.23 |
Machado et al. [19] | 58 | 10 | 9 | 0 | 0 | 1 | 0.19 |
Serenari et al. [20] | 64 | 14 | 0 | 14 | 0 | 0 | 0.51 |
Jie et al. [21] | 46.8 | 60 | 13 | 44 | 3 | 0 | 0.78 |
Overall | 59 | 119 | 52 (43.5%) | 59 (49.5%) | 3 (2%) | 6 (5%) | 0.43 |
References | ALPPS, n | Length of Surgery, Median in Min (Range) | Estimated Blood Loss, Median in Mls (Range) | Interstage Time, Median in Days, (Range) | FLVR Hypertrophy, Median in ±% (Range) | |||
---|---|---|---|---|---|---|---|---|
Stage 1 | Stage 2 | Stage 1 | Stage 2 | Stage 1 | Stage 2 | |||
Gall et al. [16] | Laparoscopic RALPPS n = 4 | Right Hepatectomy n = 4 open | 140 (105–140) | - | - | - | 23 (12–34) | +62 (53.1–95.4) |
Truant et al. [17] | Laparoscopic partial ALPPS n = 5 | Right extended hepatectomy n = 5 open | 270 (190–400) | 188 (150–280) | 250 (100–500) | 550 (100–1400) | 7.6 (6–13) | +60 (18.6–108.1) |
Jiao et al. [18] | Laparoscopic RALPPS n = 24 Robotic RALPPS n = 2 | Right hepatectomy n = 19: • 14 open • 4 laparoscopic • 1 robotic Right extended hepatectomy n = 5: • 4 open • 1 laparoscopic Not completed n = 2 | 90 (60–125) | 180 (110–390) | 310 (20–480) | 300 (50–3200) | 20 (14–36) | +80.7 (67–103.4) |
Machado et al. [19] | Laparoscopic ALPPS n = 10 | Right Hepatectomy n = 3 laparoscopic Right extended hepatectomy n = 7 laparoscopic | 300 (208–340) | 180 (140–300) | 200 (110–330) | 320 (150–800) | 21 (9–30) | +118 (42–157) |
Serenari et al. [20] | Laparoscopic ALPPS n = 7 Laparoscopic mini-ALPPS n = 6 Robotic ALPPS n = 1 (Laparoscopic partial ALPPS in 11/14) | Right hepatectomy n = 2 laparoscopic Right extended hepatectomy n = 5 laparoscopic (Converted = 2) Not completed n = 7 | 205 (187–257) | 305 (280–360) | - | - | 20 (12–27) | +62 (37–91) |
Jie et al. [21] | Laparoscopic RALPPS n = 60 | Right hepatectomy n = 32 open Right extended hepatectomy n = 28 open | 156.8 (102–227) | 305.3 (218–407) | 165 (80–280) | 628 (350–960) | 16.4 | +45.7 |
Overall Median (range) | n = 119 | n = 110 | 230 (60–400) | 258.5 (110–407) | 260 (20–500) | 1625 (50–3200) | 21 (6–36) | 87.8 (18.6–157) |
MI-ALPPS | |
---|---|
Type of tumors, n (%) | |
CRLM | 52 (43.69%) |
HCC | 59 (49.57%) |
CCA | 3 (2.52%) |
Other | 6 (5.04%) |
Split in situ variant Stage 1, n (%) | |
Classic | 13 (10.92%) |
Modified | 106 (89.07%) |
Type of hepatectomy Stage 2, n (%) | |
Right hepatectomy | 60 (54.54%) |
Right extended hepatectomy | 50 (45.45%) |
Left extended hepatectomy | 0 |
References | Length of Hospital Stay (Median, Range in Days) | CD Classification Grade ≥ 3a (%) | 90 Days Mortality (%) | |||
---|---|---|---|---|---|---|
Stage 1 | Stage 2 | Stage 1 + 2 | Stage 1 | Stage 2 | ||
Gall et al. [16] | - | - | 20 - Pulmonary thromboembolism; | - | 0 | |
Truant et al. [17] | 7 (5–9) | 12 (6–18) | 19 (11–27) | 0 | 40 - Biliary fistula - Intra-abdominal collection | 0 |
Jiao et al. [18] | 9.5 (2–17) | 8 (4–32) | 27.5 (6–49) | 3.85 - Limb compartment syndrome | 15.38 - Intra-abdominal collection - Pleural effusion - Post-operative ileus - Small bowel ischemia | 3.8 |
Machado et al. [19] | 14 (8–20) | 0 | 0 | |||
Serenari et al. [20] | 6.5 (4–9) | 12 (11–17) | 20.5 (15–26) | 14.2 | 8.3 | 0 |
Jie et al. [21] | - | 23.24 | - | 13.3 | 53.3 | 0 |
Overall Median (range) | 9.5 (2–17) | 18 (4–32) | 27.5 (6–49) | 8.14 (0–20) | 23.39 (0–53.3) | 0.6 (0–3.8) |
MI-ALPPS | |
---|---|
Interstage time, median in days ± IQR | 21 (6–36) |
FLVR hypertrophy, median in % ± IQR | 87.8 (18.6–157) |
Length of surgery, Stage 1, median in min ± IQR | 230 (60–400) |
Length of surgery, Stage 2, median in min ± IQR | 250 (110–407) |
Estimated blood loss, Stage 1, median in mls ± IQR | 260 (20–500) |
Estimated blood loss, Stage 2, median in mls ± IQR (Stage 1 and 2) | 1625 (50–3200) |
CD classification Grade > 3a, Stage 1. median in % ± IQR | 8.14 (0–24) |
CD classification Grade > 3a, Stage 2, median in % ± IQR | 23.39 (0–53.3) |
Total length of hospital stay, median in days ± IQR | 27.5 (6–49) |
90 days mortality, median in % ± IQR | 0.8 (0–3.8) |
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Cioffi, L.; Belli, G.; Izzo, F.; Fantini, C.; D’Agostino, A.; Russo, G.; Patrone, R.; Granata, V.; Belli, A. Minimally Invasive ALPPS Procedure: A Review of Feasibility and Short-Term Outcomes. Cancers 2023, 15, 1700. https://doi.org/10.3390/cancers15061700
Cioffi L, Belli G, Izzo F, Fantini C, D’Agostino A, Russo G, Patrone R, Granata V, Belli A. Minimally Invasive ALPPS Procedure: A Review of Feasibility and Short-Term Outcomes. Cancers. 2023; 15(6):1700. https://doi.org/10.3390/cancers15061700
Chicago/Turabian StyleCioffi, Luigi, Giulio Belli, Francesco Izzo, Corrado Fantini, Alberto D’Agostino, Gianluca Russo, Renato Patrone, Vincenza Granata, and Andrea Belli. 2023. "Minimally Invasive ALPPS Procedure: A Review of Feasibility and Short-Term Outcomes" Cancers 15, no. 6: 1700. https://doi.org/10.3390/cancers15061700
APA StyleCioffi, L., Belli, G., Izzo, F., Fantini, C., D’Agostino, A., Russo, G., Patrone, R., Granata, V., & Belli, A. (2023). Minimally Invasive ALPPS Procedure: A Review of Feasibility and Short-Term Outcomes. Cancers, 15(6), 1700. https://doi.org/10.3390/cancers15061700