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) thrombectom y in the treatment of the patients with hepatocellular carcinoma (HCC) and IVC t umor thrombus. Methods A retrospective study was conducted to an alyze the data of 10 patients with HCC and IVC tumor thrombus undergoing liver r esection and thrombectomy was analyzed. The surgical procedure included two part s, firstly the involving liver lobes were transected using the anterior approach without pedicle clamping, then the tumor thrombus were removed from the IVC und er total hepatic vascular exclusion (THVE). Results All lesion s 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 4 63 mL and the mean postoperative hospital stay was 12 days. One patient died of h epatic and renal function failure within 30 days after surgery. Hepatic insuffic iency 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. Conclusion Hepatocellular carcinoma with IVC tumor thr ombus is not a contraindication for surgery. Liver resection combined with IVC t hrombectomy can be safely performed.