Surgical treatment of hepatocellular carcinoma with tumor thrombus in the inferior vena cava / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To clarify the proper surgical procedure of treating hepatocellular carcinoma (HCC) with a tumor thrombus in the inferior vena cava (IVC).</p><p><b>METHODS</b>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.</p><p><b>RESULTS</b>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.</p><p><b>CONCLUSIONS</b>HCC with tumor thrombus in the IVC is operable and the proper procedure is hepatectomy plus thrombectomy.</p>