**2. References**


Fig. 7. During the THVE, the wall of the IVC was cut at the root of the left hepatic vein,

Before applying THVE, we have to assess the preoperative hepatic functional reserve and carefully monitor intraoperative hemodynamic changes (16). Our selection criteria for liver resection are the same as Makuuchi criteria (17): the resection volume of the liver is determined based on total bilirubin and the Indocyanine green retention rate at 15 minutes. However, since THVE runs the risk of ischemic liver damage, these criteria should be

In conclusion, the technique we have described here appears to be easy and beneficial in the surgical treatment of IVC tumors, since it provides a longer tumor-free margin of the IVC; short operative time; and abolishes the need for sternotomy, CPB, and cutting the pericardium. However, more experience is necessary to validate the benefits of this

[1] Taura K, Ikai I, Hatano E, Fujii H, Uyama N, Shimahara Y. Implication of frequent local

[2] Togo S, Shimada H, Tanaka K, Masui H, Fujii S, Endo I, et al. Management of

over 16 years old. *Ann Surg*. 2006; 244: 265-73.

*Hepatogastroenterology*. 1996; 43: 1165-71.

ablation therapy for intrahepatic recurrence in prolonged survival of patients with hepatocellular carcinoma undergoing hepatic resection: an analysis of 610 patients

malignant tumor with intracaval extension by selective clamping of IVC.

and tumor thrombus was exposed*.* 

determined more strictly.

approach.

**2. References** 

