[COMPLICATIONS OF SURGICAL TREATMENT OF A RENAL—CELL CANCER WITH INTRAVENOUS SPREADING].

Retrospective investigation, conducted for estimation of perioperative complications, while performing surgical treatment of a renal—cell cancer with tumoral thrombi, was presented. In 132 patients the tumoral thrombi spreading is restricted by renal vein and by vena cava inferior (VCI) as well. The patients were operated on, using the "chevron" access in the absence of artificial blood circulation.

[CREATING A CROSS-TUNNEL UNDER OSTIUM OF MAIN HEPATIC VEINS AND PIGGY BACK FUND LIVER ABLATE TUMOR THROMBUS FROM THE INFERIOR VENA CAVA].

The analysis of the effectiveness of a new method of thrombectomy, including the formation of cross-tunnel under the ostium of the main hepatic veins by removing tumor thrombus of the inferior vena cava (IVC). Successfully perform a piggy back manage to mobilize the liver in 12 (80%) patients, a tunnel formed in 4 (50%). Duration pigg back stage liver mobilization much higher than the formation of the tunnel.

[SURGICAL TECHNIQUE OF A RENAL ARTERY CONTROL WHILE REMOVAL OF TUMORAL THROMBI FROM VENA CAVA INFERIOR].

Efficacy and safety of a renal artery ligation after thrombectomy in comparison with those while using a standard surgical technique were studied. Possibility of performance and safety of thrombectomy without preliminary ligation of renal artery was proved. The results did not depend on level of intravenous tumoral spread and were significantly better, than while application of standard approaches to renal artery because of absence of embolic complications.

[ABDOMINAL TRANSDIAPHRAGMATIC EXTRAPERICARDIAL SURGICAL ACCESS TO SUPRADIAPHRAGMATIC PART OF VENA CAVA INFERIOR IN PATIENTS OPERATED FOR RENAL-CELL CANCER].

Safety and possibility to perform abdominal surgical accesses to supradiaphragmatic part of vena cava inferior (VCI) in patients, operated on for renal-cell cancer, were estimated. In 12 patients the results of application of several surgical access variants to supradiaphragmatic part of VCI were estimated. Most simple and safe way to isolate supradiaphragmatic VCI and cavaatrial junction is to perform a T-like diaphragmotomy.

Surgical Approaches to Supradiaphragmatic Segment of IVC and Right Atrium through Abdominal Cavity during Intravenous Tumor Thrombus Removal.

Objective. The purpose of this study was to investigate safety and feasibility of some surgical approaches to the supradiaphragmatic inferior vena cava (IVC) and the right atrium through the diaphragm from the abdominal cavity. Materials and Methods.