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Recent advances in the management of primary hepatic tumors refinement of surgical techniques and effect on outcome

Advances in diagnostic, anesthetic, and surgical techniques have led to significant reductions in perioperative morbidity and mortality. The preoperative factors that have been of particular importance are a careful evaluation of hepatic function and of the predicted future liver remnant (FLR) volume prior to a decision on the feasibility of resection. Better patient selection, increased understanding of the liver anatomy leading to anatomical resections has together led to marked improvement in outcomes. In this article, we discuss the pre‐ and intraoperative factors, which have evolved in the last decade influencing the trend towards increased safety. We also share our technique of liver resection. J. Surg. Oncol. 2010; 101:745‐754. © 2010 Wiley‐Liss, Inc.