Anastasia Murtha-Lemekhova1, Juri Fuchs1, Erik Schulz1, Anthe Sterkenburg1, Pascal Probst2, Katrin Hoffmann3. 1. Department of General, Visceral, and Transplantation Surgery, Ruprecht Karl University, Heidelberg, Germany. 2. 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. 3. Department of General, Visceral, and Transplantation Surgery, Ruprecht Karl University, Heidelberg, Germany. Electronic address: katrin.hoffmann@med.uni-heidelberg.de.
Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
Authors: Juri Fuchs; Anastasia Murtha-Lemekhova; Lucas Rabaux-Eygasier; Markus Kessler; Fabian Ruping; Patrick Günther; Katrin Hoffmann Journal: Front Pediatr Date: 2022-05-30 Impact factor: 3.569
Authors: Anastasia Murtha-Lemekhova; Juri Fuchs; Miriam Teroerde; Ute Chiriac; Rosa Klotz; Daniel Hornuss; Jan Larmann; Markus A Weigand; Katrin Hoffmann Journal: Antibiotics (Basel) Date: 2022-05-12
Authors: Anastasia Murtha-Lemekhova; Juri Fuchs; Svenja Feiler; Erik Schulz; Miriam Teroerde; Eva Kalkum; Rosa Klotz; Adrian Billeter; Pascal Probst; Katrin Hoffmann Journal: BMC Med Date: 2022-01-28 Impact factor: 8.775