Minimally Invasive Approach in the Setting of ALPPS Procedure: a Systematic Review of the Literature

Melandro, Fabio; Giovanardi, Francesco; Hassan, Redan; Laureiro, Zoe Larghi; Ferri, Flaminia; Rossi, Massimo; Mennini, Gianluca; Pawlik, Timothy M.; Lai, Quirino

doi:10.1007/s11605-018-04092-x

Cited by 38 publications

(26 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Laparoscopic ALPPS has been performed since 2012 7 only in few centres and has shown promising results with lower morbidity rate associated to reduced surgical severity when compared with open procedure 8,9 . Robotic liver resection has emerged as a promising approach, mainly for malignant neoplasm including colorectal liver metastases and HCC.…”

Section: Introductionmentioning

confidence: 99%

Total robotic ALPPS approach for hepatocellular carcinoma in cirrhotic liver

Fernandes

Barros

Magistri

et al. 2021

Robotics Computer Surgery

View full text Add to dashboard Cite

Background Hepatocellular carcinoma (HCC) is a common indication for associating liver partition with portal vein ligation for staged hepatectomy (ALPPS). Robotic liver resection has been done for HCC, but robotic ALPPS is a rare procedure. Methods To present three cases of totally robotic ALPPS in cirrhotic patients with HCC. Results Three cirrhotic male patients with HCC underwent ALPPS; the mean age was 54.3 years. MELD score was ≤9 and tumour size between 90 and 140 mm. The mean hypertrophy of the future liver remnant after the first stage was 77.5% and no postoperative liver failure was reported. Mean operative time of stage 1 was 7:30 h and of stage 2 was 4:37 h, without blood transfusion. The mean hospital stay for the first stage was 10 days and for the second stage was 9.3 days. No postoperative complication was recorded. Conclusions Robotic ALPPS in cirrhotic patients with HCC is safe and feasible.

show abstract

Section: Introductionmentioning

confidence: 99%

Total robotic ALPPS approach for hepatocellular carcinoma in cirrhotic liver

Fernandes

Barros

Magistri

et al. 2021

Robotics Computer Surgery

View full text Add to dashboard Cite

show abstract

“…In 2016, Machado et al reported their experience with 10 laparoscopic ALPPS compared to 20 open cases, showing that laparoscopic approach reduces intraoperative blood loss and severe postoperative complications at both stages 1 and 2, resulting in a shorter total hospital stay . Although in that series there is no evidence of a reduced interval between stages 1 and 2 by adopting a minimally invasive approach, laparoscopic and robotic stage 1 may reduce the rate of uncompleted ALPPS or delayed stage 2 thanks to the lower incidence of perioperative morbidity . Currently, several centers prefer minimally invasive approaches over classical open procedures to reduce the incidence of morbidity .…”

Section: Discussionmentioning

confidence: 99%

“…16 Although in that series there is no evidence of a reduced interval between stages 1 and 2 by adopting a minimally invasive approach, laparoscopic and robotic stage 1 may reduce the rate of uncompleted ALPPS or delayed stage 2 thanks to the lower incidence of perioperative morbidity. 5 Currently, several centers prefer minimally invasive approaches over classical open procedures to reduce the incidence of morbidity. 17 In our institution, we developed a minimally invasive liver surgery program, which led to 60% of cases being treated with robotic or laparoscopic approach for liver resection each year, and we benefit of funds from a specific regional health care program on robotic HCC resection.…”

Section: Discussionmentioning

confidence: 99%

“…A new player in this field is the application of minimally invasive approaches to ALPPS. As reported in a recent review of the literature, currently, 27 cases of minimally invasive ALPPS have been reported, 26 of whom were completed laparoscopically or robotically in both ALPPS stages 1 and 2 . Among those, only one case of full robotic ALPPS was described by Vicente et al in 2016 for a case of multiple liver metastasis from sigmoid adenocarcinoma .…”

Section: Introductionmentioning

confidence: 99%

“…As reported in a recent review of the literature, currently, 27 cases of minimally invasive ALPPS have been reported, 26 of whom were completed laparoscopically or robotically in both ALPPS stages 1 and 2. 5 Among those, only one case of full robotic ALPPS was described by Vicente et al in 2016 for a case of multiple liver metastasis from sigmoid adenocarcinoma. 6 Later on, one case of robotic stage 1 7 and one case of full robotic partial ALPPS 8 for colorectal liver metastases were published.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Full robotic ALPPS for HCC with intrahepatic portal vein thrombosis

Benedetto

Assirati

Magistri

2020

Robotics Computer Surgery

View full text Add to dashboard Cite

Background The associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) technique can induce a greater degree of hypertrophy of the future liver remnant (FLR) in a shorter time compared with other procedures. A robotic approach may reduce the complication rate, increasing the ability to perform classic ALPPS. Methods We report technical and clinical considerations on the first full robotic ALPPS (stages 1 and 2) for hepatocellular carcinoma (HCC) with portal vein intrahepatic tumor thrombus. Results The patient was a 38‐year‐old man with Milan‐out HCC and FLR volume of 19.6%. On postoperative day (POD) 8, FLR increased to 37%; therefore, he underwent completion of ALPPS on POD 10. The postoperative course was uneventful, and the patient was discharged in good general conditions on POD 3. Conclusion Robotic ALPPS is safe and feasible for selected patients with initially unresectable HCC or requiring extended resections, with good postoperative outcomes.

show abstract

Oncological benefits of portal vein embolization for patients with hepatocellular carcinoma

Beppu

Yamamura

Okabe

et al. 2020

Annals of Gastroent Surgery

View full text Add to dashboard Cite

Portal vein embolization (PVE) has been carried out for various hepatobiliary malignancies such as hepatocellular carcinoma (HCC). 1-9 PVE for HCC was first introduced in 1986 by the Osaka City University group in Japan. 1 PVE is mainly done to obtain a larger future liver remnant (FLR) to expand the safety zone of liver resection. Even for HCC patients with fibrous livers, liver resectability is increased after PVE without increasing morbidity and mortality. 3,5,7 Previous studies have assessed liver resectability based on liver function and FLR volume using computed tomography (CT)volumetry. [8][9][10][11] Nowadays, functional liver volumetry using 99m Tc-galactosyl human serum albumin scintigraphy single-photon emission CT is used to assess partial liver function after PVE. 12-16 PVE can provide a larger functional volume of the FLR as compared to those before PVE. Additionally, the functional volume ratio after PVE has

show abstract

Minimally Invasive Approach in the Setting of ALPPS Procedure: a Systematic Review of the Literature

Cited by 38 publications

References 44 publications

Total robotic ALPPS approach for hepatocellular carcinoma in cirrhotic liver

Total robotic ALPPS approach for hepatocellular carcinoma in cirrhotic liver

Full robotic ALPPS for HCC with intrahepatic portal vein thrombosis

Oncological benefits of portal vein embolization for patients with hepatocellular carcinoma

Contact Info

Product

Resources

About