A Meta-Analysis Of Safety And Efficacy Of ALPPS And Two-Stage Hepatectomy In Patients With Colorectal Cancer With Hepatic Metastasis

Objective: In recent years,ALPPS has been the treatment of choice for residual liver volume(FLR)in patients with colorectal cancer liver metastases(CRLM).The aim of this study was to use a meta-analysis to comprehensively assess the safety and efficacy of ALPPS and two-stage hepatectomy(TSH)in the treatment of CRLM.Methods: By searching the PUBMED,EMBASE,and Cochrane library databases,the time range was from January 2013 to January 2019.Based on the inclusion and exclusion criteria and literature quality assessment,randomized controlled trials and reviews of ALPPS and TSH for CRLM were selected.Sexual cohort study.Statistical analysis of FLR increase rate,two-stage surgical interval,postoperative major complication rate,R0 resection rate,90-day mortality,and overall survival rate using Revman 5.3(Review Manager 5.3).Results: This analysis included 5 studies involving a total of 335 CRLM patients,including 128 patients in the ALPPS group and 207 patients in the TSH group.Meta-analysis showed that the ALPPS group was superior to the TSH group in the three-step operation interval,the operation completion rate,and the 1-year postoperative tumor-free survival rate(P<0.05).However,it is more prone to serious postoperative complications(P<0.05).There was no significant difference between the ALPPS group and the TSH group in the three aspects of FLR increase rate,R0 resection rate and postoperative 90-day mortality rate(P>0.05).Conclusion: Compared with the TSH group,ALPPS can complete two-step operation in a shorter period of time,and the two-stage operation completion rate and the 1-year disease-free survival rate after surgery are higher,indicating that ALPPS is more effective;and the ALPPS group is more effective.The incidence of serious complications is higher than that of the TSH group,indicating that its safety is lower than that of the TSH group..