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Sequential Portal V...
Sequential Portal Vein Embolization and Percutaneous Radiofrequency Ablation for Future Liver Remnant Growth: A Minimally Invasive Alternative to ALPPS Stage-1 in Treatment of Hepatocellular Carcinoma
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- Wang, Q (författare)
- Karolinska Institutet
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Ji, YJ (författare)
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- Brismar, TB (författare)
- Karolinska Institutet
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Chen, S (författare)
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Li, CF (författare)
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Jiang, JY (författare)
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Mu, W (författare)
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Zhang, LD (författare)
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- Sparrelid, E (författare)
- Karolinska Institutet
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Ma, KS (författare)
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(creator_code:org_t)
- 2021-09-30
- 2021
- Engelska.
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Ingår i: Frontiers in surgery. - : Frontiers Media SA. - 2296-875X. ; 8, s. 741352-
- Relaterad länk:
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https://www.frontier...
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http://kipublication...
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https://doi.org/10.3...
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Abstract
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- Background: To evaluate the feasibility and efficacy of sequential portal vein embolization (PVE) and radiofrequency ablation (RFA) (PVE+RFA) as a minimally invasive variant for associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) stage-1 in treatment of cirrhosis-related hepatocellular carcinoma (HCC).Methods: For HCC patients with insufficient FLR, right-sided PVE was first performed, followed by percutaneous RFA to the tumor as a means to trigger FLR growth. When the FLR reached a safe level (at least 40%) and the blood biochemistry tests were in good condition, the hepatectomy was performed. FLR dynamic changes and serum biochemical tests were evaluated. Postoperative complications, mortality, intraoperative data and long-term oncological outcome were also recorded.Results: Seven patients underwent PVE+RFA for FLR growth between March 2016 and December 2019. The median baseline of FLR was 353 ml (28%), which increased to 539 (44%) ml after 8 (7–18) days of this strategy (p < 0.05). The increase of FLR ranged from 40% to 140% (median 47%). Five patients completed hepatectomy. The median interval between PVE+RFA and hepatectomy was 19 (15–27) days. No major morbidity ≥ III of Clavien-Dindo classification or in-hospital mortality occurred. One patient who did not proceed to surgery died within 90 days after discharge. After a median follow-up of 18 (range 3–50) months, five patients were alive.Conclusion: Sequential PVE+RFA is a feasible and effective strategy for FLR growth prior to extended hepatectomy and may provide a minimally invasive alternative for ALPPS stage-1 for treatment of patients with cirrhosis-related HCC.
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Till lärosätets databas
- Av författaren/redakt...
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Wang, Q
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Ji, YJ
-
Brismar, TB
-
Chen, S
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Li, CF
-
Jiang, JY
-
visa fler...
-
Mu, W
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Zhang, LD
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Sparrelid, E
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Ma, KS
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visa färre...
- Artiklar i publikationen
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Frontiers in sur ...
- Av lärosätet
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Karolinska Institutet