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Associating liver partition and portal vein ligation for staged hepatectomy in patients with colorectal liver metastases--Intermediate oncological results.

https://arctichealth.org/en/permalink/ahliterature274971
Source
Eur J Surg Oncol. 2016 Apr;42(4):531-7
Publication Type
Article
Date
Apr-2016
Author
B. Björnsson
E. Sparrelid
B. Røsok
E. Pomianowska
K. Hasselgren
T. Gasslander
B A Bjørnbeth
B. Isaksson
P. Sandström
Source
Eur J Surg Oncol. 2016 Apr;42(4):531-7
Date
Apr-2016
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Colorectal Neoplasms - mortality - pathology - surgery
Female
Hepatectomy - methods
Humans
Incidence
Liver Neoplasms - mortality - secondary - surgery
Male
Middle Aged
Neoplasm Metastasis
Norway - epidemiology
Portal Vein - surgery
Postoperative Complications - epidemiology
Prognosis
Retrospective Studies
Survival Rate - trends
Sweden - epidemiology
Treatment Outcome
Abstract
Colorectal liver metastases (CRLM) not amenable for resection have grave prognosis. One limiting factor for surgery is a small future liver remnant (FLR). Early data suggests that associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) effectively increases the volume of the FLR allowing for resection in a larger fraction of patients than conventional two-stage hepatectomy (TSH) with portal vein occlusion (PVO). Oncological results of the treatment are lacking. The aim of this study was to assess the intermediate oncological outcomes after ALPPS in patients with CRLM.
Retrospective analysis of all patients with CRLM operated with ALPPS at the participating centres between December 2012 and May 2014.
Twenty-three patients (16 male, 7 female), age 67 years (28-80) were operated for 6.5 (1-38) metastases of which the largest was 40 mm (14-130). Six (27.3%) patients had extra-hepatic metastases, 16 (72.7%) synchronous presentation. All patients received chemotherapy, 6 cycles (3-25) preoperatively and 16 (70%) postoperatively. Ten patients (43%) were rescue ALPPS after failed PVO. Severe complications occurred in 13.6% and one (4.5%) patient died within 90 days of surgery. After a median follow-up of 22.5 months from surgery and 33.5 months from diagnosis of liver metastases estimated 2 year overall survival was 59% (from surgery) and 73% (from diagnosis). Liver only recurrences (n = 8), were treated with reresection/ablation (n = 7) while lung recurrences were treated with chemotherapy.
The overall survival, rate of severe complications and perioperative mortality associated with ALPPS for patients with CRLM is comparable to TSH.
PubMed ID
26830731 View in PubMed
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The New National Registry for Gastrointestinal Surgery in Norway: NoRGast.

https://arctichealth.org/en/permalink/ahliterature296886
Source
Scand J Surg. 2018 Sep; 107(3):201-207
Publication Type
Journal Article
Date
Sep-2018
Author
K Lassen
L S Nymo
H Kørner
K Thon
T Grindstein
H H Wasmuth
T Moger
B A Bjørnbeth
S Norderval
M T Eriksen
A Viste
Author Affiliation
1 Gastrointestinal Surgery, University Hospital of North Norway, Tromsø, Norway.
Source
Scand J Surg. 2018 Sep; 107(3):201-207
Date
Sep-2018
Language
English
Publication Type
Journal Article
Keywords
Digestive System Diseases - epidemiology - surgery
Digestive System Surgical Procedures - statistics & numerical data
Humans
Norway - epidemiology
Quality Improvement - statistics & numerical data
Registries - statistics & numerical data
Abstract
There is an increasing demand for high-quality data for the outcome of health care. Diseases of the gastro-intestinal tract involve large patient groups often presenting with serious or life-threatening conditions. Complications may affect treatment outcomes and lead to increased mortality or reduced quality of life. A continuous, risk-adjusted monitoring of major complications is important to improve the quality of health care to patients undergoing gastrointestinal resections. We present the development of the Norwegian Registry for Gastrointestinal Surgery, a national registry for colorectal, upper gastrointestinal, and hepato-pancreato-biliary resections in Norway.
A narrative and qualitative presentation of the development and current state of the registry.
We present the variables and the analysis tools and provide examples for the potential in quality improvement and research. Core characteristics include a strictly limited set of variables to reflect important risk factors, the procedure performed, and the clinical outcomes.
A registry with the potential to present complete national cohort data is a powerful tool for quality improvement and research.
PubMed ID
29628007 View in PubMed
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