title: [Surgical treatment of hepatocellular carcinoma with tumor thrombus in the inferior vena cava].
abstract: 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.
authors.affiliation: Eastern Hepatobility Surgery Hospital, Second Military Medical University, Shanghai 200438, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Wang
authors.forename: Han
authors.initials: H
authors.lastname: Chen
authors.forename: Meng-chao
authors.initials: MC
authors.lastname: Wu
authors.forename: Yan-fu
authors.initials: YF
authors.lastname: Sun
authors.forename: Chuan
authors.initials: C
authors.lastname: Lin
authors.forename: Xiao-qing
authors.initials: XQ
authors.lastname: Jiang
authors.forename: Gong-tian
authors.initials: GT
authors.lastname: Wei
mesh_terms: 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*