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Two-stage hepatectomy and associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) in treating liver metastases of rectal cancer: a case report

Overview of attention for article published in SpringerPlus, April 2015
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Title
Two-stage hepatectomy and associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) in treating liver metastases of rectal cancer: a case report
Published in
SpringerPlus, April 2015
DOI 10.1186/s40064-015-0965-z
Pubmed ID
Authors

Yusuke Ome, Kazuyuki Kawamoto, Tae Bum Park, Tadashi Ito, Keizo Ogasahara

Abstract

An innovative approach, called associated liver partition and portal vein ligation for staged hepatectomy(ALPPS), has made possible a marked increase in future liver remnant (FLR) volume over a short period of time, thus permitting extended hepatectomy. This report describes ALPPS in a 63-year-old male patient with rectal cancer and synchronous multiple liver metastases. The primary lesion was resected, followed by chemotherapy. We had planned to completely resect the metastases in both liver lobes, but CT volumetry revealed a very small FLR (364 ml, 29% of the total liver volume, 0.61% of total body weight). His indocyanine green retention rate at 15 minutes was 12.7%. Because of the risk of tumor progression in the interim, we performed ALPPS. During the first stage, the tumor in segment 3 was resected, the right lobe was mobilized, the liver was partitioned, and the right portal vein was ligated. The right hepatic artery, duct and vein were secured with vessel loops. CT on postoperative day 6 showed sufficient FLR increase (from 364 ml to 573 ml, or from 0.61% to 0.96% of total body weight) and ICGR15 improvement to 3.4%. The second stage of ALPPS was on postoperative day 7, completing resection of the metastases. The patient recovered well and was discharged 21 days after the second step. The ALPPS approach has many advantages, but it lacks evidence of long-term results. Considering the high mortality and morbidity rates of ALPPS, it is essential to evaluate its risks and benefits in individual patients and determine the strict criteria for this surgical method. ALPPS procedure rapidly increases FLR, permitting extended hepatectomy for patients with initially insufficient FLR.

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Geographical breakdown

Country Count As %
Unknown 17 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 5 29%
Other 4 24%
Researcher 2 12%
Student > Doctoral Student 1 6%
Professor > Associate Professor 1 6%
Other 1 6%
Unknown 3 18%
Readers by discipline Count As %
Medicine and Dentistry 13 76%
Psychology 1 6%
Unknown 3 18%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 April 2016.
All research outputs
#18,449,393
of 22,858,915 outputs
Outputs from SpringerPlus
#1,260
of 1,849 outputs
Outputs of similar age
#193,582
of 265,508 outputs
Outputs of similar age from SpringerPlus
#37
of 53 outputs
Altmetric has tracked 22,858,915 research outputs across all sources so far. This one is in the 11th percentile – i.e., 11% of other outputs scored the same or lower than it.
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