Meta-analysis of the outcomes of associating liver partition and portal vein ligation for staged hepatectomy versus portal vein embolization for the treatment of liver cancer with insufficient future liver remnant
10.3760/cma.j.issn.0529-5815.2019.07.012
- VernacularTitle: ALPPS与门静脉栓塞二步法肝切除术治疗剩余肝体积不足的肝脏恶性肿瘤的临床疗效的Meta分析
- Author:
Yanlong CAO
1
;
Guijie WANG
2
;
Wei LI
2
Author Information
1. Department of General Surgery, the Fourth Hospital of Xi′an, Xi′an 710004, China
2. Department of Hepatobiliary-Pancreatic Surgery, China-Japan Union Hospital of Jilin University, Changchun 130033, China
- Publication Type:Journal Article
- Keywords:
Liver neoplasms;
Meta analysis;
Associating liver partition and portal vein ligation for staged hepatetomy;
Portal vein embolization
- From:
Chinese Journal of Surgery
2019;57(7):540-548
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the feasibility, safety and efficacy of associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) and portal vein embolization (PVE) for the treatment of liver cancer with insufficient future liver remnant (FLR) .
Methods:The data regarding the clinical controlled trials in comparison of ALPPS and PVE in liver surgery were collected from the both domestic and international publications searched through the datebases of PubMed, Cochrane Library, Embase, CNKI, and VIP.Meta analysis was performed by RevMan 5.3 software.
Results:Total 10 studies with clinical control were analyzed (9 cohort studies and 1 randomized controlled study) .A total of 620 patients were included, with 165 cases in ALPPS group, 455 cases in PVE group.Results of Meta-analysis showed that there was statistically significant difference (P<0.05) between the two groups in the completion rate of two-steps surgery (OR=6.04, 95%CI: 2.97-12.31, Z=4.96) , FLR growth rate (MD=19.91, 95% CI: 8.64-31.18, Z=3.46) , two-steps surgical interval (MD=-30.48, 95%CI: -37.87--23.09, Z=8.09) , and R0 resection rate (OR=2.29, 95%CI=1.07-4.90, Z=2.13) .While there was no significant differences between the two groups in the mortality rate of postoperative within 90-days, postoperative the total complication rates, postoperative liver failure, and total hospital stay (all P>0.05) .
Conclusions:Compared to the PVE procedures, ALPPS appears an effective treatment method for liver tumor with insufficient FLR.Therefore, the applications of ALPPS and PVE are limited and depending on further investigation.
