Complex liver resection for hepatic tumours involving the inferior vena cava

Gennaro Nuzzo, Felice Giuliante, Marco Giordano, S. Lopez Ben, M. Albiol, J. Figueras

Risultato della ricerca: Contributo in rivistaArticolo in rivistapeer review

39 Citazioni (Scopus)


BACKGROUND: Resection of liver tumours with involvement of inferior vena cava (IVC) is considered to have a high surgical risk. AIM: We retrospectively reviewed 23 patients who underwent hepatectomy with IVC resection in two West-European liver surgery Units. METHODS: The tumours included liver metastases (n = 13), hepatocellular carcinoma (n = 4), intrahepatic cholangiocarcinoma (n = 3), liver haemangioma (n = 1), primary hepatic lymphoma (n = 1) and recurrent right adrenal gland carcinoma (n = 1). RESULTS: IVC resection was associated with right hepatectomy in 8 cases, extended right hepatectomy in 9 cases, extended left hepatectomy in 3 cases, minor liver resection in 2 cases, and right hepatectomy with nephrectomy in one case. In 16 patients the IVC wall involvement was <30% of its circumference, and a tangential vena cava resection was performed. In 7 patients (30%) with >50% involvement, a caval segment was resected and replaced with a 20 mm ringed polytetrafluoroethylene graft. R0-resection was achieved in all patients. Median intraoperative blood loss was 1.100 ml (range 490-15,000). Fourteen patients were transfused with a median of 3 PRC units per patient (range 1-25). Major complications occurred in 9 patients. Postoperative stay in ICU was 2.3 ± 3.4 days (range 1-14) and hospital stay was 17.3 ± 2.6 days (range 5-62). In 14 patients, final pathology demonstrated microscopic IVC infiltration. CONCLUSIONS: In selected patients with malignant involvement of the liver and IVC, surgical resection en bloc with IVC is the only possibility to achieve R0 resection, with acceptable mortality and morbidity, in units specialized in liver surgery.
Lingua originaleEnglish
pagine (da-a)921-927
Numero di pagine7
RivistaEuropean Journal of Surgical Oncology
Stato di pubblicazionePubblicato - 2011


  • Caval resection
  • Complex liver resections
  • Liver resections
  • Liver tumors
  • Vena cava involvement

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