Application of radiofrequency ablation assisted ALPPS in liver cancer patients with insufficient future liver remnant
10.3760/cma.j.cn113884-20220513-00211
- VernacularTitle:射频消融辅助的ALPPS在剩余肝体积不足肝癌患者中的应用分析
- Author:
Ying CHEN
1
;
Xiaofei WANG
;
Kai FENG
;
Yujun JI
;
Qingsong DENG
;
Kuansheng MA
Author Information
1. 陆军军医大学第一附属医院全军肝胆外科研究所，重庆 400038
- Keywords:
Carcinoma, hepatocellular;
Radiofrequency ablation;
Associating liver partition and portal vein ligation for staged hepatectomy;
Future liver remnant
- From:
Chinese Journal of Hepatobiliary Surgery
2022;28(11):812-816
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the apply effect of radiofrequency ablation assisted associating liver partition and portal vein ligation for staged hepatectomy (RALPPS) in liver cancer patients with insufficient future liver remnant (FLR).Methods:The data of 29 patients who underwent RALPPS in the First Affiliated Hospital of the Army Military Medical University from June 2014 to July 2020 were analyzed, including 25 males and 4 females, aged (46.6±9.9) years. The patients were divided into the second stage group (completed the second stage operation, n=18) and the first stage group (completed only the first stage operation, n=11) according to whether they had successfully completed the second stage operation. FLR, percentage of FLR in standard liver volume (percentage of FLR), growth rate of FLR, liver function after operation, operation time and radiofrequency ablation time of first stage operation, surgical complications were compared between the two groups. Results:The percentage of FLR before the first stage operation was (30.0±7.0)% in 29 patients, and the second stage operation was completed in 18 patients (62.1%). After the first stage operation, the aspartate aminotransferase and alanine aminotransferase in the second stage group were 519.0 (362.9, 696.0) U/L and 391.8 (297.2, 591.1) U/L, which were better than those of the first stage group 931.0 (711.7, 1131.9) U/L and 851.3 (426.6, 888.0) U/L (both P<0.05). There was no significant difference between the two groups in FLR and percentage of FLR before the first stage operation, duration time, amount of bleeding and time of radiofrequency ablation of the first stage operation (all P>0.05). In the second stage group, the interval between two operations was (21.6±6.7) days, the FLR before the second stage operation was (623.2±101.8) cm 3, the FLR percentage was (49.0±7.0)%, and the FLR growth rate was (19.0±5.0)%. In the first stage group, there were 11 patients (100.0%) who developed complication after first stage operation, induding 7 patients (63.6%) with complication above Clavien-Dindo grade Ⅲb. In the second stage group, 18 patients (100.0%) developed complication after the first stage operation. There were no complication above grade Ⅲb. The causes of 11 patients who did not completed secondary surgery included poor liver function and insufficient FLR in 4 patients, tumor progression in 6 patients, and death in 1 patient. Conclusion:RALPPS is a therapeutic option for liver cancer patients with insufficient FLR, and the therapeutic effect is reasonable.
