Hepatocellular carcinoma(HCC) is one of the most common malignancies of the digestive system,which is prone to be associated with microvascular or macrovascular invasion. Among them,HCC with inferior vena cava tumor thrombus(IVCTT) or right atrium tumor thrombus(RATT) is rare and has a poor prognosis. However,surgical treatment of HCC with IVCTT and (or) RATT is rarely reported and summarized. The review described the classification of HCC tumor thrombus with IVCTT and (or) RATT, summarized the progress of surgical approaches and surgical operations,and introduced a case of thrombectomy after pushing from the outer surface of the atrium,rendering the RATT to the inferior vena cava under non-cardiopulmonary bypass. The review also proposed the prospective treatments for HCC with IVCTT or RATT,providing clinical guidance to hepatobiliary surgeons.
原发性肝细胞癌是消化系统的常见恶性肿瘤，易侵犯微血管及大血管系统。在肝细胞癌累及大血管系统患者中，合并下腔静脉癌栓（IVCTT）或右心房癌栓（RATT）为较少见的肿瘤疾病状态，患者预后极差，且针对此类患者的外科治疗目前多为散在报道。本文对原发性肝细胞癌合并IVCTT和（或）RATT的癌栓分型进行阐述，就外科手术方式进展与外科手术操作进展进行综述，并结合自身外科经验介绍非体外循环下从心房外推出RATT进入下腔静脉后取栓的临床经验，希望为肝细胞癌合并IVCTT和（或）RATT的治疗提供参考。.