title: An approach to intrapericardial inferior vena cava through the abdominal cavity, without median sternotomy, for total hepatic vascular exclusion.
abstract: In surgical resection for hepatocellular carcinoma with tumor thrombus extending into the inferior vena cava and other malignancies involving the retrohepatic inferior vena cava, the usefulness of total hepatic vascular exclusion has been reported by several authors. Total hepatic vascular exclusion usually consists of clamping at three points; at the infrahepatic inferior vena cava, at the suprahepatic inferior vena cava, and in Pringles' maneuver. Tumor thrombus extending into the inferior vena cava at the intrapericardial level below the right atrium can be resected without the use of cardio-pulmonary bypass. The inferior vena cava at the intrapericardial level has been reported to be usually approached by median sternotomy such as Chevron incision. We herein demonstrate an approach to the intrapericardial inferior vena cava through the abdominal cavity without median sternotomy.
authors.affiliation: Department of General Surgery, School of Medicine, Chiba University, 1-8-1, Inohana, Chuoh-ku, Chiba, 260-0856, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Miyazaki
authors.forename: H
authors.initials: H
authors.lastname: Ito
authors.forename: K
authors.initials: K
authors.lastname: Nakagawa
authors.forename: H
authors.initials: H
authors.lastname: Shimizu
authors.forename: H
authors.initials: H
authors.lastname: Yoshidome
authors.forename: Y
authors.initials: Y
authors.lastname: Shimizu
authors.forename: M
authors.initials: M
authors.lastname: Ohtsuka
authors.forename: A
authors.initials: A
authors.lastname: Togawa
authors.forename: F
authors.initials: F
authors.lastname: Kimura
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000098:blood supply* / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply* / Q000601:surgery; D008297:Male; D009360:Neoplastic Cells, Circulating; D010496:Pericardium / Q000601:surgery*; D014682:Vena Cava, Inferior / Q000601:surgery*