[SURGICAL TREATMENT OF THE HEPATOCARCINOMA]

Surgery is the treatment for Hepatocarci noma, and with it the best results in relation to term of time free from this disease and survival are obtained. Therefore, it is the chosen treatment.At present, liver resection is performed with a mortality below 5 per cent.Prior to tumor resection, the extension of the disease should be determined (by means of echography, computed tomography-CT and x-ray of the lungs). Hepatic function must also be measured (total bilirubins and albumin), and it is necessary to know if the patient suffers cirrhosis or not.Patients with adequate hepatic function and a resectable localizated Hepatocarcinoma should undergo tumor resection which borders shall be free from neoplasm. The resection extension is determined bythe neoplasm size and localization and it can vary from a wedge resection to a extended Hepatectomy or transplantation.Couinaud Classification must be used to describe the type of resection carried out. During resection, several approach techniques to hepatic parenchyma, portal fissure, and vena cava shall be combined (total vascular exclusion), in order to minimize blood loss, for blood transfusion affects negatively in survival.When the size of the tumor is smaller than 3 cm in diameter, the best survival results, up to 5 years, are obtained either with partial Hepatectomy or transplantation.