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Evolution of minimally invasive techniques and surgical outcomes of ALPPS in Italy: a comprehensive trend analysis over 10 years from a national prospective registry by Matteo Serenari; Francesca Ratti; Nicola Guglielmo; Matteo Zanello; Federico Mocchegiani; Jacopo Lenzi; Michele Colledan; Vincenzo Mazzaferro; Umberto Cillo; Alessandro Ferrero; Matteo Cescon; Fabrizio Di Benedetto; Marco Massani; Gianluca Grazi; Raffaele Dalla Valle; Marco Vivarelli; Giuseppe Maria Ettorre; Luca Aldrighetti; Elio Jovine; Stefania Camagni; Fabio Forchino; Enrico Gringeri; Salvatore Gruttadauria; Paolo Magistri; Bruno Nardo; Matteo Ravaioli; Fabrizio Romano; Maurizio Romano; Andrea Scarinci; Matteo Virdis; Giacomo Zanus; ALPPS Italian Registry is a Medicine article available to read on EtoBox.

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Background Since 2012, Associating Liver Partition and Portal vein ligation for Staged hepatectomy (ALPPS) has encountered several modifications of its original technique. The primary endpoint of this study was to analyze the trend of ALPPS in Italy over a 10-year period. The secondary endpoint was to evaluate factors affecting the risk of morbidity/mortality/ post-hepatectomy liver failure (PHLF). Methods Data of patients submitted to ALPPS between 2012 and 2021 were identified from the ALPPS Italian Registry and evaluation of time trends was performed. Results From 2012 to 2021, a total of 268 ALPPS were performed within 17 centers. The number of ALPPS divided by the total number of liver resections performed by each center slightly declined (APC = − 2.0%, p = 0.111). Minimally invasive (MI) approach significantly increased over the years (APC = + 49.5%, p = 0.002). According to multivariable analysis, MI completion of stage 1 was protective against 90-day mortality (OR = 0.05, p = 0.040) as well as enrollment within high-volume centers for liver surgery (OR = 0.32, p = 0.009). Use of interstage hepatobiliary scintigraphy (HBS) and biliary tumors were independent predictors of PH

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Author

Matteo Serenari; Francesca Ratti; Nicola Guglielmo; Matteo Zanello; Federico Mocchegiani; Jacopo Lenzi; Michele Colledan; Vincenzo Mazzaferro; Umberto Cillo; Alessandro Ferrero; Matteo Cescon; Fabrizio Di Benedetto; Marco Massani; Gianluca Grazi; Raffaele Dalla Valle; Marco Vivarelli; Giuseppe Maria Ettorre; Luca Aldrighetti; Elio Jovine; Stefania Camagni; Fabio Forchino; Enrico Gringeri; Salvatore Gruttadauria; Paolo Magistri; Bruno Nardo; Matteo Ravaioli; Fabrizio Romano; Maurizio Romano; Andrea Scarinci; Matteo Virdis; Giacomo Zanus; ALPPS Italian Registry

Publisher

Springer Science and Business Media LLC

Published

2023

Language

EN

Field

Medicine (Health Sciences)