Updates in surgery
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Comparative Study
Our initial experience with ALPPS technique: encouraging results.
Surgical resection is the best option for prolonged survival in patients with primary or secondary liver tumors. A sufficient future liver remnant (FLR) volume is needed to prevent post-hepatectomy liver failure (PHLF). With the aim of increasing FLR, a new two-step technique has been recently developed. ⋯ With a mean follow-up of 187 days, disease-free survival and overall survival were 80 and 100 %, respectively. ALPPS induces a great and fast FLR hypertrophy allowing R0 resections in patients otherwise considered unresectable because of small FLR volume, without severe PHLF and low mortality in experience centers. Further experience is needed to determine long-term outcomes.
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Traumatic abdominal wall hernia (TAWH) is a muscle-fascial rupture due to a blunt direct or indirect trauma. High energy trauma is the principal cause of TAWH and they are consequence of car accidents in 50-70% and motorcycle in 15-20%. ⋯ Surgical treatment can be urgent or secondary according to the lesions of the patient. Visceral complications secondary to TAWH are extremely rare and they are difficult to treat.