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Transcatheter arterial embolization-salvaged ALPPS, a novel ALPPS procedure especially for patients with hepatocellular carcinoma and severe fibrosis/cirrhosis

作     者:Yuanfei Peng Zheng Wang Xudong Qu Feiyu Chen Huichuan Sun Xiaoying Wang Zhenbing Ding Min Tang Lei Yu Xinrong Yang Qiang Gao Zhaoyou Tang Wan Yee Lau Jia Fan Jian Zhou 

作者机构:Department of Liver Surgery and TransplantationLiver Cancer InstituteZhongshan HospitalFudan UniversityKey Laboratory of Carcinogenesis and Cancer InvasionMinistry of EducationFudan UniversityShanghaiChina Department of Interventional RadiologyZhongshan HospitalFudan UniversityShanghaiChina Department of RadiologyZhongshan HospitalFudan UniversityShanghaiChina Faculty of MedicineThe Chinese University of Hong KongPrince of Wales HospitalShatinHong KongChina Institute of Biomedical SciencesFudan UniversityShanghaiChina State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and DevelopmentSchool of Life SciencesFudan UniversityShanghaiChina Shanghai Key Laboratory of Organ TransplantationShanghaiChina 

出 版 物:《Hepatobiliary Surgery and Nutrition》 (肝胆外科与营养(英文))

年 卷 期:2022年第11卷第4期

页      面:504-514,I0001-I0003页

核心收录:

学科分类:1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基  金:This work was supported by grants from the National Natural Science Foundation of China(No.82150004) 

主  题:Associating liver partition and portal vein ligation for staged hepatectomy(ALPPS) transcatheter arterial embolization(TAE) hepatocellular carcinoma(HCC) cirrhosis fibrosis 

摘      要:Background:The associating liver partition and portal vein ligation for staged hepatectomy(ALPPS)for hepatocellular carcinoma(HCC)with fibrosis/cirrhosis is often associated with limited growth of future liver remnant(FLR).We introduced a new procedure named transcatheter arterial embolization-salvaged ALPPS(TAE-salvaged ALPPS)which was shown to be especially suitable for HCC patients with cirrhosis or fibrosis who failed adequately to respond to conventional *** short-term efficacy and safety for the TAE-salvaged ALPPS on patients with HCC and fibrosis/cirrhosis were ***:Consecutive HCC patients who underwent TAE-salvaged ALPPS in our hospital between November 2016 and June 2020 were retrospectively *** new ALPPS procedure included conventional ALPPS stage-1 using associating liver partition and portal vein *** FLR failed to reach sufficient hypertrophy,TAE was carried out 2 weeks later followed by liver resection 3 weeks after ALPPS ***:Nine of 10 patients had a single tumor(median diameter 14.0 cm,range,5.2-17 cm).The remaining patient had multiple tumors(diameter of one tumor 14.0 cm,and two satellite foci 2.0 and 3.0 cm).R0 resection was achieved in all patients(100%)after a median of 21 *** patients had cirrhosis,1 had METAVIR grade-3 fibrosis,and 3 had METAVIR grade-2 *** median increase in FLR volume after TAE-salvaged ALPPS was 69.7%(34.4-143.9%).The absolute and relative kinetic growth rates(KGRs)were 9.9(7.1-17.3)mL/day and 3.4%(1.9-7.2%)/day,*** median absolute KGRs were 15.7,2.6,and 19.5 mL/day in the first,second,and third postoperative weeks after ALPPS stage-1,*** rapid increase in KGR on the third week was induced by *** overall postoperative morbidity rates were 50,0%(5/10),20.0%(2/10)and 70.0%(7/10)after ALPPS stage-1,TAE and ALPPS stage-2,*** 90-day mortality rate was 10.0%(1/10).The median overall survival was 40 ***:The new TA

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