[Surgery for patients with hepatocellular carcinoma and inferior vena cava tumor thrombus].
OBJECTIVE
To investigate the surgical procedure, safety and efficacy of liver resection with inferior vena cava (IVC) thrombectomy in the treatment of the patients with hepatocellular carcinoma (HCC) and IVC tumor thrombus.


METHODS
A retrospective study was conducted to analyze the data of 10 patients with HCC and IVC tumor thrombus undergoing liver resection and thrombectomy was analyzed. The surgical procedure included two parts, firstly the involving liver lobes were transected using the anterior approach without pedicle clamping, then the tumor thrombus were removed from the IVC under total hepatic vascular exclusion (THVE).


RESULTS
All lesions and tumor thrombus were successfully removed. The mean operation and THVE time were 202 and 22 minutes respectively. The mean intraoperative blood loss was 1,463 mL and the mean postoperative hospital stay was 12 days. One patient died of hepatic and renal function failure within 30 days after surgery. Hepatic insufficiency was seen in four cases and was successfully treated. The rest experienced uneventful postoperative recovery course. One patient died in the perioperative period and the rest had the postoperative life span ranging from 3 months to 19 months.


CONCLUSIONS
Hepatocellular carcinoma with IVC tumor thrombus is not a contraindication for surgery. Liver resection combined with IVC thrombectomy can be safely performed.
Department of Hepatic-Bilio-Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Tao
T
Zhang
Department of Hepatic-Bilio-Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Ji-Wei
JW
Huang
Department of Hepatic-Bilio-Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
Yong
Y
Zeng
D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009360:Neoplastic Cells, Circulating; D017131:Thrombectomy / Q000379:methods*; D013927:Thrombosis / Q000209:etiology / Q000601:surgery*; D014682:Vena Cava, Inferior / Q000601:surgery*