Our findings indicate that the ACTICON artificial anal sphincter is well tolerated and can be an effective alternative in the treatment of severe anal incontinence. Although complete continence is only achieved in a low percentage of cases, for the rest of the patients the ACTICON neosphincter reduces the symptoms considerably.

The 5-year recurrence-free (RFS) and overall survival (OS) rates in patients with ND-CLM (28.1% and 29.0%) were worse than those without ND-CLM (39.5% [p= 0.0079], 58.1% [p =0.0010]). In multivariate analysis, having ND-CLM was found to be an independent risk factor of impaired RFS (hazard ratio =1.81, p =0.0385) and OS (hazard ratio =2.06, p =0.0165 ). Conclusions: Detection of new lesions during hepatectomy negatively impacts on survival in patients undergoing surgery for colorectal liver metastases.

Los bosques templados costeros pluviales de la Patagonia austral y Tierra del Fuego cons- tituyen una expresión florística y ecológica de características propias y muy distintas al resto de las formaciones vegetales del continente americano (Pisano, 1997). Aquellos de carác- ter “primario” o en estados sucesionales avan- zados son actualmente remanentes escasos de los procesos antrópicos de degradación ambiental relacionados a la extracción y explo- tación de recursos naturales, que sobreviven gracias a su aislamiento de caminos o rutas de explotación, o bien, por su resguardo geográ- fico a eventos climáticos de gran envergadura (i.e. volteo masivo por temporales de viento) (Pisano, 1997; Promis, Cruz, Reif &Gärtner, 2008). Conservan en su estructura información de enorme y singular valor ecológico, siendo testigos vivos de procesos ambientales y paleoclimáticos, estrechamente ligados a las dinámicas históricas del paisaje litoral de los canales patagónicos (Holz, Haberle, Veblen, De Pol Holz, Southon, 2012; Koch & Kilian, 2002; Villagrán, 2018)but rarely on both. In this study of fire history in western Patagonia (47-48° S. A su vez, es de esperar, que dichas dinámicas podrían comprender en parte o en su totali- dad, una historia estrechamente ligada al ser humano, al menos desde el retroceso glacial y posterior ocupación de los canales patagó- nicos por cazadores recolectores marinos o pueblos canoeros (Emperaire, 1955).

Background: Due to the unfavorable reported outcome in ALPPS, a precise risk stratification is needed. Based on the International ALPPS Registry, we have recently proposed two easily applicable risk models (pre-stage1 and 2) for predicting 90-day mortality in ALPPS but a validation of both models has not yet been performed. Methods: One year after the development of the ALPPS risk model, the ALPPS registry was screened for subsequent cases not used for the development cohort (DC) of the risk model. Four centers outside the ALPPS registry were contacted to provide additional ALPPS cases. Pre-stage 1 and 2 futility risks were calculated for each patient according to the developed risk formula. ROC curve analysis was performed to assess the predictive ability of the ALPPS risk model in the validation cohort (VC). Results: The VC was composed of a total of 176 patients including 36 patients outside the ALPPS registry with 30 cases of early mortalities (17%). The DC and VC were comparable in terms of patient and surgery characteristics. The VC validated both models with an acceptable prediction for the pre-stage 1 (c-statistic 0.62, p=0.041 vs. 0.75, p<0.001) and an excellent prediction for the pre-stage 2 model (c-statistic 0.82, p<0.001 vs. 0.84, p<0.001) as compared to the DC. Conclusion: The ALPPS risk score is a validated tool to assess the individual risk of patients before stage-1 and stage-2 surgery. Risk adjustment in ALPPS using the risk score is an easy applicable strategy to make this procedure safer.

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