Hybrid transileocecal portal vein embolization associated with staging laparoscopy for planned major hepatectomy in advanced hepatobiliary cancers.
Hybrid transileocecal portal vein embolization associated with staging laparoscopy for planned major hepatectomy in advanced hepatobiliary cancers.
复制标题
混合式经回盲部门静脉栓塞术与分期腹腔镜检查相关，用于晚期肝胆癌计划的主要肝切除术。
DOI：
10.1007/s00423-020-02034-3
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Tajima Y.
中科院分区：
文献类型：
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作者：
Kawabata Y;Hayashi H;Yoshida R;Ando S;Nakamura K;Nishi T;Nakamura M;Tajima Y.
背景门静脉栓塞术（PVE）被广泛应用于促进未来残肝（FLR）肥大和减少术后肝功能衰竭。本研究的目的是评估经盲肠门静脉栓塞术（TIPE）与分期腹腔镜检查（混合LAP-TIPE）的计划肝切除术在先进的hepatobiliary cancer. Methodshybrid LAP-TIPE程序包括分期腹腔镜检查的腹腔肿瘤细胞减灭术和随后的TIPE的完整筛选的有效性。回顾性收集了2013年3月至2020年2月期间进行的Hybrid lap-TIPE的数据。ResultsHybrid lap-TIPE用于52例患者，42例患者完成了后续TIPE（80.8%），因为分期腹腔镜检查发现13例患者存在潜在或不可切除的因素（25.0%），其中2例肝细胞癌和1例结直肠癌肝转移患者因FLR内的隐匿性病灶接受了腹腔镜肿瘤细胞减灭术。最后，36例患者（69.2%）完成了根治性肝切除术，其中3例患者接受了肿瘤细胞减灭术。最常见的手术是扩大的右半肝切除术（50.0%），其次是右半肝切除术（30.6%），其中包括3例肝胰管切除术。混合式腹腔镜肝动脉内栓塞术和肝切除术的总发病率分别为7.1%和41.7%。混合式腹腔镜肝动脉内栓塞术和肝切除术的死亡率分别为0%和5.6%。2年生存率和2年无病生存率分别为64.8%和61.9%，分别后hepatectic.ConclusionsHybrid lap-TIPE是安全的，可能是一个有用的治疗方案，为晚期肝胆癌患者，因为它可以帮助确定最佳的候选人PVE后，有计划的肝切除术。
BackgroundPortal vein embolization (PVE) is widely used to promote the hypertrophy of a future liver remnant (FLR) and reduce posthepatectomy liver failure. The aim of this study was to evaluate the efficacy of transileocecal portal embolization (TIPE) associated with staging laparoscopy (hybrid lap-TIPE) for a planned hepatectomy in advanced hepatobiliary cancers.MethodsThehybrid lap-TIPE procedure consisted of staging laparoscopy for complete screening of the abdominal cavity with cytoreductive surgery and subsequent TIPE. Data onhybrid lap-TIPE, performed between March 2013 and February 2020, were collected retrospectively.ResultsHybrid lap-TIPE was conducted for 52 patients, and a subsequent TIPE was accomplished in 42 patients (80.8%), since staging laparoscopy detected latent or unresectable factors in 13 patients (25.0%), among which 2 patients with hepatocellular carcinoma and 1 with colorectal liver metastasis received laparoscopic cytoreductive surgery for latent lesions in the FLR. Finally, radical hepatectomy was completed in 36 patients (69.2%), including 3 patients who underwent cytoreductive surgery. The most common operation was an extended right hepatectomy (50.0%), followed by right hepatectomy (30.6%), including 3 hepatopancreatoduodenectomies. The overall morbidity associated withhybrid lap-TIPE and hepatectomy was 7.1% and 41.7%, respectively. The mortality associated withhybrid lap-TIPE and hepatectomy was 0% and 5.6%, respectively. The rates of 2-year survival and 2-year disease-free survival were 64.8% and 61.9%, respectively, after hepatectomy.ConclusionsHybrid lap-TIPE is safe and could be a useful treatment option for patients with advanced hepatobiliary cancer because it can help to identify optimal candidates for PVE followed by a planned hepatectomy.