A Meta Analysis Of Clinical Efficacy Of ALPPS And PVE Two-step Hepatectomy In Treatment Of Huge Liver Cancer

Objective To compare the clinical efficacy of Assocaiting Liver Partition and Portal Vein Ligation for Staged Hepatectomy(ALPPS)and Portal Vein Embolization(PVE)two-step hepatectomy in the treatment of huge liver cancer.Methods:The relevant clinical literatures about the comparison of ALPPS and PVE two-step hepatectomy were searched.The literatures were selected according to the designed inclusion and exclusion criteria.The study data were collected and Meta-analyzed by using Review Manager,Stata SE 12.0 and other software.Results:11 articles were included,with a total number of 751 cases,including 213(28.36%)in the ALPPS group and 538(71.64%)in the PVE two-step hepatectomy group.There were no significant differences in preoperative age,gender,ASA grade,tumor size,number and chemotherapy between the two groups(P>0.05),and the BMI in the ALPPS group was smaller than that in the PVE two-step hepatectomy group(P<0.05).There was no significant difference in preoperative FLR between the two groups(P>0.05),and there was no significant difference in FLR before the second operation between the two groups(P>0.05).The surgical interval time was significantly shorter in the ALPPS group than in the PVE two-step hepatectomy group(P<0.05),the FLR growth rate was higher in the ALPPS group than in the PVE two-step hepatectomy group(P<0.05),and the second phase completion rate was higher in the ALPPS group than in the PVE two-step hepatectomy group(P<0.05).There was no significant difference in the incidence of surgical complications(P>0.05),incidence of major complications(P>0.05)and postoperative mortality(P>0.05)between the ALPPS group and the PVE two-step hepatetomy group.Conclusion:The current evidence suggests that ALPPS and PVE two-step hepatectomy have similar safety and efficacy,but ALPPS can achieve similar FLR in a shorter time than PVE two-step hepatectomy.