Surgical treatment of hepatocellular carcinoma with inferior vena cava tumor thrombosis: report of 11 cases / 中国普通外科杂志

ABSTRACT

ObjectiveThis study was to review our experience for the management of hepatocellular carcinoma(HCC) invading the inferior vena cava(IVC). Methods Eleven patients were operated on. Tumors were first resected under portal triad clamping(PTC) and then the tumor emboli in the IVC were removed either under hepatic vascular exclusion(HVE) or under side clamping of the IVC. Results Surgery was successful in all cases, without operative death and complication caused by the removals of tumor emboli from the IVC. The mean operative time was 179 min (range 120～255 min) and the mean intraoperative blood loss 1 482 ml(range 600～3 000 ml). The mean PTC and HVE times were 27 9 min(range 12～83 min) and 16 5 min(range 7～28 min), respectively. The postoperative complications included pleural effusion in one needing thorancentesis and bile leak in one. During the follow up, 3 patients died at 30, 10 and 14 months, respectively, and the remaining 8 patients were alive at the follow up of 1 to 14 months. ConclusionsHCC with tumor thrombus in the IVC is operable and the proper procedure is hepatectomy plus thrombectomy with a favourable postoperative prognosis.