Variation on a Theme: Alternative to Plastic Bag in ALPPS Procedures: Feasibility and Clinical Safety of COVA+™ Membrane in ALPPS Procedures

World Journal of Surgery
Raffaele BrustiaOlivier Soubrane

Abstract

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. 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. 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. To our knowledge, this is the first clinical study evaluating ...Continue Reading

Citations

Sep 25, 2019·Materials Science & Engineering. C, Materials for Biological Applications·Alibi BaitukhaFarzaneh Arefi-Khonsari

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