Associating liver partition and portal vein ligation for staged hepatectomy in the treatment of colorectal cancer liver metastases

Table 1 Key modalities of the associating liver partition and portal vein ligation for staged hepatectomy technique

ALPPS strategies	Technical points
Classical ALPPS	Right portal vein ligation and right trisectionectomy
Rescue ALPPS	Failure of PVE with subsequent ALPPS
Laparoscopic ALPPS	Laparoscopy for stage 1 or both stages 1 and 2
PVE ALPPS	The intentional use of PVE as part of the first stage is stated by using PVE-ALPPS
Partial ALPPS	Transection at least 50% of the future transection plane at stage 1
Left ALPPS	Left portal vein ligation, left trisectionectomy
Tourniquet ALPPS	Tourniquet in the umbilical fissure and portal vein occlusion
Radiofrequency ALPPS	Radio-frequency-assisted liver partition
Microwave ALPPS	Microwave transection of the liver
Monosegment ALPPS	Extending hepatectomy, only sparing a single or adjacent segment

ALPPS: Associating liver partition and portal vein ligation for staged hepatectomy; PVE: Portal vein embolization.

Table 2 Outcome characteristics[25]

Variable	Number of patients	Data completion	Value
Interstage interval, d	468	92%	13 (9–21)
Stage 2 performed, n (%)	510	100%	492 (96)
R0 resection at stage 2, n (%)	302	59%	220 (73)
90-d mortality, n (%)	510	100%	25 (5)
Complications ≥ 3B stage 1, n (%)	501	98%	37 (7)
Complications ≥ 3B stage 2, n (%)	485	95%	100 (21)

The cohort included 510 patients with colorectal liver cancer metastasis who underwent associating liver partition and portal vein ligation for staged hepatectomy during the 10-year period from 2009 to 2019 in 22 international centers. Citation: Petrowsky H, Linecker M, Raptis DA, Kuemmerli C, Fritsch R, Kirimker OE, Balci D, Ratti F, Aldrighetti L, Voskanyan S, Tomassini F, Troisi RI, Bednarsch J, Lurje G, Fard-Aghaie MH, Reese T, Oldhafer KJ, Ghamarnejad O, Mehrabi A, Abraham MET, Truant S, Pruvot FR, Hoti E, Kambakamba P, Capobianco I, Nadalin S, Fernandes ESM, Kron P, Lodge P, Olthof PB, van Gulik T, Castro-Benitez C, Adam R, Machado MA, Teutsch M, Li J, Scherer MN, Schlitt HJ, Ardiles V, de Santibañes E, Brusadin R, Lopez-Lopez V, Robles-Campos R, Malagó M, Hernandez-Alejandro R, Clavien PA. First Long-term oncologic results of the ALPPS procedure in a large cohort of patients with colorectal liver metastases. Annals of surgery 2020; 272: 793-800. Copyright© 2020 Wolters Kluwer Health, Inc.