title: Repeated hepatic resection combined with inferior vena cava replacement: Case report and review of literature.
abstract: BACKGROUND
  Advanced tumors of the liver involving the inferior vena cava (IVC) have always been considered a contraindication to surgery.
  
  
  METHODS
  We report a case of a patient, who previously underwent right hepatectomy, with recurrence of colorectal liver metastasis invading the IVC. The patient had a liver resection together with replacement of the vena cava using a ringed polytetrafluoroethylene (PTFE) graft tube. The operation was carried out in hepatic vascular exclusion (HVE) without the use of veno-venous bypass. The patient was healthy and tumor-free at 6 months post-surgery.
  
  
  CONCLUSIONS
  In patients with hepatic malignancy involving the IVC, extended hepatic resection and reconstruction of the IVC is often the prerequisite to obtaining a resection margin.
  
  
  CONCLUSIONS
  Extended hepatic resection with IVC reconstruction for hepatic malignancy may offer a chance of cure to selected patients who otherwise have poor survival rates.
authors.affiliation: Ravenna Hospital, AUSL Romagna, HBP and General Surgery Unit, Randi 5, 48121 Ravenna, Italy. Electronic address: guerrinigp@yahoo.it.
authors.forename: Gian Piero
authors.initials: GP
authors.lastname: Guerrini
authors.affiliation: Ravenna Hospital, AUSL Romagna, HBP and General Surgery Unit, Randi 5, 48121 Ravenna, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Soliani
keywords: Hepatic resection; Inferior vena cava; Liver segment anatomy; Liver tumor