Key result
Anesthetic advances lowering central venous pressure enable safe liver resections with low morbidity and mortality.
Why the study?
Advances in anesthetic and surgical techniques have transformed liver resections into safer procedures with low morbidity and mortality, but a comprehensive description of current anesthetic strategies is needed.
Advances in anesthetic strategies, including ERAS protocols and techniques to reduce intrahepatic blood volume, have transformed liver resections into safe procedures with low morbidity and mortality.
May support low-CVP techniques in liver surgery; leaves open prospective RCTs to define optimal protocols.
Advances in anesthetic and surgical, new technologies and deep knowledge pathophysiological techniques have allowed in recent decades transform liver resections in safe surgery with low morbidity and mortality.The reduction of intraoperative bleeding was the main factor contributing to consolidate a high survival rate, standardizing technical and encouraging a greater number of procedures worldwide.Reducing the volume of intrahepatic blood is the pillar of this intervention, because since its application began to perform liver surgery without significant bleeding.Anesthetic strategies as reducing PVC or increased variation of combined systolic (VPS), when necessary, with the use of surgical Pringle maneuver or total vascular exclusion stimulated surgeons progress in Collisions of increasingly sophisticated and complex liver, unimaginable only a few years ago.In addition to highly complex surgeries, they have adopted common to all her techniques, based on the universal concept of fast track and ERAS (enhanced recovery after surgery) for controlling and optimizing perioperative condition of patients.The use of protective ventilation, glycemic control, peritoperatorios correct replacement fluids, and preservation of renal function and a placement cardiovacular an effective pain treatment have resulted in a clear decrease of mechanical ventilation, ICU stay and hospital stay.In this presentation techniques that can be used today for liver resection of varying complexity, with a high degree of safety they are described.
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A 2017 study conducted a review in Liver resection. Anesthetic and surgical strategies (e.g., low central venous pressure, Pringle maneuver) was evaluated. Advances in anesthetic and surgical techniques, particularly the reduction of central venous pressure and intrahepatic blood volume, have transformed liver resections into safe procedures with low morbidity and mortality.
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