Published in:
01-12-2015 | Innovative Surgical Techniques Around the World
Variation on a Theme: Alternative to Plastic Bag in ALPPS Procedures: Feasibility and Clinical Safety of COVA+™ Membrane in ALPPS Procedures
Published in: World Journal of Surgery | Issue 12/2015
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Background
Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) got wide success among hepatic surgeons as an efficient way to shorten to 7 days from the 4 weeks interval of classic 2-staged hepatectomy. The main disadvantage of ALPPS is the onset of inflammatory adhesions, particularly on the hepatic pedicle region, previously dissected. The aim of the study is the evaluation of a resorbable collagen membrane (CM) indicated in the prevention of postoperative adhesions as an alternative to the use of a plastic bag (PB) during ALPPS procedure.
Methods
All patients undergoing ALPPS procedure in our department were prospectively included in a database. At the end of the first surgery, at least one resorbable CM (COVA+™, Biom’Up, France) was placed instead of a PB. Intraoperative adhesions during the second step and clinical short-term safety were assessed.
Results
Ten patients with a mean age of 57.5 years underwent a 2-staged hepatectomy through ALPPS approach. At the second stage, 90 % of the patients experienced either grade-0 (no adhesion) or grade-I adhesions (mild adhesions easily divided). None of the reported complications were related to the use of the CM.
Conclusion
To our knowledge, this is the first clinical study evaluating the use of an anti-adhesion resorbable CM as a safe and efficient alternative to PB in ALPPS procedures.