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Objective To: investigate the safety and efficacy of radical nephrectomy plus inferior vena cava thrombectomy,to evaluate the efficacy of preoperative temporary inferior vena cava filter placement and intraoperative application of the liver harvesting surgical technique to expose the inferior vena cava,in order to avoid tumor thrombosis embolism shedding.Methods: The data of 42 cases(January 2004 to December 2010,Department of Urology,Zhongshan Hospital)of RCC involving the inferior vena cava were analyzed retrospectively.All patients received radical nephrectomy plus inferior vena cava thrombectomy.Patients were grouped according to the location of the tumor thrombus,and were implanted with a temporary inferior vena cava filter as routine preoperative treatment.For those patients with tumor thrombi behind the liver,the liver harvesting surgical technique was applied to separate and turn the liver to the left to expose the inferior vena cava,and thus the blood flow was blocked to accomplish the inferior vena cava thrombectomy.The filter was removed postoperatively on the same day.A routine follow-up study was performed.Results: All 42 cases were performed operation successfully and did not show any symptom of tumor thrombus embolism perioperatively.One patient died of severe postoperative lung infection.The average operation time was 220 min and the average blood loss was 750 ml.12 patients received blood transfusion with an average transfusion volume of 800 ml.The average follow-up time was 36 months.15 of 37 cases without preoperative tumor metastasis showed postoperative metastases,and the other 22 cases showed tumor-free survival.Conclusions: Nephrectomy and inferior vena cava thrombectomy is more safe and effective for patients suffering from renal cell carcinoma with subdiaphragmmatic thrombosis.Preoperative temporary inferior vena cava filter placement and intraoperative application of the liver harvesting surgical technique to expose the inferior vena cava can effectively prevent tumor thrombosis embolism shedding and improve surgical safety.