[Hepatic metastases of colonic and rectal carcinoma: surgical treatment (author's transl)].

Statistical results show a marked improvement in survival after surgical treatment of hepatic metastases. The possibilities of surgery are evaluated after precise analysis of the lesions seen at the time of excision and not at autopsy. The data from assessment which indicate that surgery will be successful are described and discussed. Surgical techniques consist above all of resection: metastasectomy, segmentectomy, hemihepatectomy and hepatectomy followed by transplant. Other methods are palliative. Certain resections themselves appear to be palliative and the ideal is to carry out adequate resection at the outset, adapted to the size and site of the lesions. However the possibilities of surgery form part of an overall programme: -- complete removal of the primary carcinoma in order to avoid any local recurrence, -- wide eradication of metastatic lesions, -- préventive treatment against further development of possible subclinical lesions by post-surgical chemotherapy and subsequent immunotherapy.