We suggest that with the development of improved technical devices and more experience, the indications for laparoscopic colectomy should continue to expand. The low incidence of infectious complications suggests an important role for the laparoscopic approach to colorectal surgery.

Laparoscopic resection for Crohn's disease can be performed safely and effectively. Quicker resumption of oral feeds, less postoperative pain and earlier discharge from hospital are advantages of the laparoscopic method. No differences in the recurrence rate or the disease-free interval were noted.

The use of a NR period before total body cooling improves survival of liver transplantation in NHBDs. Portal blood flow and pump blood flow measurements can predict the viability of the grafts.

Laparoscopic resection for colorectal cancer can be performed safely and effectively in tertiary centers. Earlier discharge from hospital, quicker resumption of oral feeds and less postoperative pain are clear advantages. No adverse effect on recurrence or survival was noted, but results of prospective, randomized trials, currently underway, are needed before laparoscopic resection for colorectal cancer becomes the standard of practice.

1-8 To reduce the intensity of these hemodynamic ent perioperative periods (anesthesia induction, hepa-derangements, venovenous bypass (VVBP) from infetectomy, anhepatic phase, biliary anastomosis, and 24 rior caval vein and portal vein territories to superior hours after surgery). A significant decrease in inulin caval vein territory was introduced in 1984.9,10 In addiclearance and increase in tubular damage markers were tion to its beneficial hemodynamic effect during the observed in the anhepatic phase, which only partly imanhepatic phase of liver transplantation, VVBP has proved in the subsequent phases. No significant differences were observed between groups 1 and 2 at any peri-been suggested by several authors to protect the kidoperative phase, except during the anhepatic phase, in neys from the damage secondary to the interruption which a more marked renal function impairment oc-of renal venous outflow. 3,10 Because of these potential curred in group 2 patients. However, renal function on benefits of VVBP, a number of transplant centers are the 7th postoperative day and the need for hemodialysis/ routinely performing VVBP during orthotopic liver hemofiltration during the 1st week were similar in both transplantation. 6,11 However, the systematic use of groups. Among 40 variables analyzed, only low mean ar-VVBP has been questioned by other authors who have of VVBP on perioperative renal function in patients PATIENTS AND METHODS

The aim of this study was to compare the possible role of normothermic recirculation with the role of liver transplants from non-heart-beating donor pigs after 20 min of cardiac arrest. Three groups were studied, of which two were control groups: group 1, in which the liver was harvested from a heart-beating donor; group 2, in which the liver was harvested after a period of cardiac arrest followed by total body cooling; and group 3, in which the liver was procured as in group 2, but including a period of 30 min of cardiopulmonary bypass and tissue oxygenation at 37 degrees C before total body cooling. Survival at 5 days; endothelial (hyaluronic acid) and hepatocellular damage (AST, ALT, and alpha-GST); adenine nucleotides (energy charge), and histological changes were evaluated. Normothermic recirculation during 30 min showed a significant effect on survival (p = .03), endothelial damage (p < .05), and histological changes after reperfusion (p = .04). Cardiopulmonary bypass significantly increased the energy charge during the normothermic recirculation period (p = .001). Moreover, this study shows that a significant survival (100%) can be achieved with a liver allograft after 20 min of cardiac arrest. Although the liver suffers a major insult in terms of endothelial damage and hepatocellular damage, lesions caused by the ischemic injury are reversible. Histological changes also indicate lesion reversibility, since they almost disappear after 5 days.

Identification of prognostic factors may help in the selection of the appropriate treatment for these patients with HCC and cirrhosis.

Preliminary results of this study were presented at the XVI World Congress of the Transplantation Society, Barcelona, Spain, August 1996 J. C. Garcia Abstract The aim of this study was to compare the possible role of normothermic recirculation with the role of liver transplants from nonheart-beating donor pigs after 20 min of cardiac arrest. Three groups were studied, of which two were control groups: group 1, in which the liver was harvested from a heart-beating donor; group 2, in which the liver was harvested after a period of cardiac arrest followed by total body cooling; and group 3, in which the liver was procured as in group 2, but including a period of 30 rnin of cardiopulmonary bypass and tissue oxygenation at 37 "C before total body cooling. Survival at 5 days; endothelial (hyaluronic acid) and hepatocellular damage (AST, ALT, and a-GST); adenine nucleotides (energy charge), and histological changes were evaluated. Normothermic recirculation during 30 rnin showed a significant effect on survival ( p = .03), endothelial damage (p < .05), and histological changes after reperfusion (p = .04). Cardiopulmonary bypass significantly increased the energy charge during the normothermic recirculation period ( p = .001). Moreover, this study shows that a significant survival (100 % ) can be achieved with a liver allograft after 20 rnin of cardiac arrest. Although the liver suffers a major insult in terms of endothelial damage and hepatocellular damage, lesions caused by the ischemic injury are reversible. Histological changes also indicate lesion reversibility, since they almost disappear after 5 days.