Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy Offers High Oncological Feasibility With Adequate XXXX Safety: A Prospective Study at a Single Center.

@entity1184 @entity1 @entity409 @entity96
OBJECTIVE:: To determine the safety, feasibility, and efficacy of @entity96 (ALPPS) in a single high-volume hepatobiliary center. BACKGROUND:: The ALPPS approach allows achieving resectability of @entity409 by a rapid and large future liver remnant (FLR) @entity1184 . However, this proposal has been associated with high morbidity and mortality rates. METHODS:: This was a single-cohort, prospective, observational study [NCT02164292]. Between June 2011 and April 2014, @entity1 with @entity409 considered unresectable due to an insufficient FLR who underwent ALPPS were included. RESULTS:: Thirty @entity1 were treated. Median age was 58.6 years (range = 35-81) and 19 @entity1 were males (63%). In a median of 6 days (range = 4-67), the median FLR @entity1184 was 89.7% (range = 21-287). Twenty-nine @entity1 completed the second stage (97% feasibility). Morbidity according to the Dindo-Clavien classification was 53% (grade >= IIIa 43% and grade >= IIIb 31%). The mortality rate was 6.6%. Total parenchymal transection was identified as an independent risk factor for complications (P = 0.049). There was not significant difference in terms of FLR @entity1184 between total or partial parenchymal transection (P = 0.45). Median hospital stay was 16 days (range = 11-62). The overall and disease-free survival at 1 year was 78% and 67% and at 2 years was 63% and 40%, respectively. CONCLUSIONS:: This prospective study on the largest reported single-center experience shows that ALPPS has acceptable morbidity and mortality, together with a high oncological feasibility and @entity1184 efficacy. Partial parenchymal transection seems to reduce morbidity without negatively impacting FLR @entity1184 .
