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The growing clinical impact of radiofrequency ablation of liver lesions is reflected by a rapidly increasing number of published papers. Experimental work focuses on factors that reduce the variability of the ablation zone. The Pringle-maneuver plays a key role in this question from a surgeon's perspective. Large single center studies and a meta-analysis show a sharp rise in the rate of local recurrences for tumors larger 3 cm. An open surgical approach is significantly correlated to a low local recurrence rate. Bile duct lesions and intrahepatic abscesses are the most frequent complications. Intraductal bile duct cooling can prevent these complications. Three prospective randomized trials support the use of RFA for small hepatocellular carcinoma. The use of RFA in patients with multiple colorectal metastases is supported by single center studies showing a 3 year survival of35%. The favourable cost / benefit ratio will make RFA a part of future multimodal cancer therapy concepts.

A two-step procedure is suggested to reduce the overall operative risk in patients with colorectal cancer and large synchronous liver metastases, which demand an extended right hemihepatectomy for R0 resection.The clinical course and volumetric evaluation of the liver is described in three patients in whom preliminary ligation of the right branch of the portal vein was performed at the time of colon resection.The size of the left lateral lobes increased by 9.9%, 13.7%, and 4.9% of total liver volume, respectively. At the same time, the noninfiltrated part of the right lobes shrunk by 36.7%, 36%, and 6% ukereas metastatic growth was 26.8%, 22.3%, and 12%. After 7 weeks, extended right hemihepatectomy could be performed in all three patients without signs of hepatic insufficiency, yielding R0 resection.Can reduce the risk for extended right hemihepatectomy in selected patients with synchronous colorectal liver metastases.