[Tumor thrombosis of the inferior vena cava in renal carcinoma extending to the upper hepatic margin--surgical technique].

The authors divide the invasion of a tumourous thrombus of renal cell carcinoma into the IVC, consistent with the surgical approach of this problem into three levels. They describe in detail the approach and solution of the thrombus which reached as far as the upper hepatic margin or as far as the passage of the IVC through the diaphragm. Separation of the IVC between the liver and the path of the IVC into the right atrium from the median upper section from the xiphoid two fingers beneath the umbilicus seems the optimal and safe approach to tumourous thrombosis reaching that far. Using this approach at the Urological Clinic in Hradec four patients were operated. At present the authors consider other approaches to tumourous thrombosis of the IVC of renal cell carcinoma reaching up to the upper hepatic margin less suitable and associated with a higher risk of possible tumourous embolism of the pulmonary artery.