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Surgery for liver metastases

Various strategies have been designed to increase the resectability of advanced liver tumours, including downstaging chemotherapy, portal vein and transarterial embolisations, two-stage hepatectomy, local ablation techniques and, in highly selected cases, extracorporeal liver surgery. With this integrated and multidisciplinary approach, we have observed a substantial increase in the number of patients who can ultimately benefit from surgery. Liver metastases from colorectal cancer are commonly treated, but secondaries from other tumours are also considered for surgery, the commonest being neuroendocrine, breast and renal cancer.

An increasingly larger proportion of liver resections is now performed laparoscopically, enhancing a prompt recovery, without affecting oncological radicality. With this minimally invasive technique, patients are usually discharged within a few days of the operation and return to a normal activity and lifestyle in two to three weeks. For this purpose, two state-of-the-art theatres have been recently built with advanced laparoscopic equipment.