D.V. Shchukin, V.N. Lesovoy, Y.A. Garagatyy, N.N. Poliakov, G.G. Khareba, P.V. Mozzakov

Surgery of “high” tumor thrombus of the inferior vena cava without piggy-back mobilization of the liver. New surgical approach

Presents an analysis of the effectiveness of the new technique of thrombectomy, including the formation of cross-tunnel under the mouths of the major hepatic veins. The piggyback mobilization was performed successfully in 12 (80.0%) cases, while the formation of the tunnel was possible in 4 (50.0%) cases. Duration of piggyback liver mobilization was significantly higher than the time of the tunnel formation. The frequency of bleeding and volume of blood loss were similar in both groups. Formation of cross-tunnel is recommended when retrohepatic part of the vena cava covered by the liver less than on 1/2 of the length of its circumference, or in situations where the surgeon is fully confident in ability to perform it.