Meta-analysis Of The Feasibility And Safety Of Partial Hepatectomy In The First Stage Of ALPPS

Objective: A meta-analysis was used to evaluate the safety and effectiveness of partial liver transection in the first phase of ALPPS.Methods: Comprehensive retrieval of CNKI,Wanfang,PubMed,Embase,Cochrane library database.According to the inclusion criteria,exclusion criteria and literature quality evaluation scores,the clinical observation comparative study of partial ALPPS and classic ALPPS was included.Revman 5.3 was used to analyze the outcome indexes FLR proliferation rate,interval between two operations,overall complication rate,serious complication rate,90 day mortality rate.Results: four studies were included in this analysis,including 62 patients in partial ALPPS and 85 patients in classic ALPPS groups.The results of meta-analysis showed that there was no significant difference(P > 0.05)in FLR growth rate(P = 0.44),interval time between two operations(P = 0.12)and postoperative 90 day mortality rate(P = 0.4)between partial ALPPS groups and the classic ALPPS group.There were significant differences in the incidence of total complications(grade ? 1)(P = 0.008)and serious complications(grade ? 3b)(P = 0.04)between partial ALPPS groups and classic ALPPS groups(P < 0.05).Conclusion: Partial ALPPS group can achieve the same FLR growth rate and operation interval as the classic ALPPS group.In patients without hepatic fibrosis,partial liver partition can reduce the incidence of postoperative complications,but not the mortality.