[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. Intraoperative complications rate have constituted 36.4%. The blood loss volume due to VCI injury (in 3 cases) while performing transdiaphragmatic surgical access to supradiaphragmatic part of VCI, have constituted 112.5 ml at average. Injuries of pleura, pericardium, main truncus of diaphragmatic nerve did not occur.