[Surgical treatment of hepatocellular carcinoma with tumor thrombus in the inferior vena cava].
OBJECTIVE
To clarify the proper surgical procedure of treating hepatocellular carcinoma (HCC) with a tumor thrombus in the inferior vena cava (IVC).


METHODS
Four patients with HCC with a tumor thrombus in the IVC underwent hepatectomy and thrombectomy. Following hepatectomy, tumor thrombus was removed by incising the wall of the IVC in 3 patients and from the hepatic vein in one patient. The 3 patients underwent thrombectomy under either hepatic vascular exclusion (HVE) or Satinsky's vascular clamping.


RESULTS
All the operations were successful without operative death and major complications. The postoperative course was uneventful in 3 patients and pleural effusion occurred in one patient who needed thoracentesis. Follow-up showed 3 patients died after 30, 10 and 14 months, respectively, and one patient is alive for 7 months.


CONCLUSIONS
HCC with tumor thrombus in the IVC is operable and the proper procedure is hepatectomy plus thrombectomy.
Wang
Yi
Y
Eastern Hepatobility Surgery Hospital, Second Military Medical University, Shanghai 200438, China.
Chen
Han
H
Wu
Meng-chao
MC
Sun
Yan-fu
YF
Lin
Chuan
C
Jiang
Xiao-qing
XQ
Wei
Gong-tian
GT
D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000601:surgery*; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating; D014682:Vena Cava, Inferior / Q000473:pathology*