目的 提高肾癌(RCC)伴下腔静脉(IVC)癌栓的手术治疗效果。方法 对4例RCC伴IVC癌栓患者在施行肾癌根治性切除。淋巴结清除的同时分别选择行IVC切开、IVC壁切除和IVC节段切除取癌栓术。结果 手术均获成功,无大出血、肺梗塞,术后血尿素氮、肌酐均无明显异常。随访13～34月患者均健在。结论 对本病应采取积极的手术治疗。三种手术方案的选择应取决于癌栓的长度、水平、分型等。 Objective To improve the surgical treatment of renal cell carcinoma (RCC) associated with IVC tumor thrombus. Methods Four cases of RCC with IVC tumor thrombus were performed radical resection of renal cell carcinoma. Lymphadenectasis were selected at the same time line IVC incision, IVC wall resection and IVC resection to take the tumor embolism. Results The operation was successful, no major bleeding, pulmonary infarction, postoperative blood urea nitrogen, creatinine were no significant abnormalities. All patients were followed up from 13 to 34 months. Conclusion This disease should be taken active surgical treatment. The choice of three surgical options should depend on the length of the thrombus, level, type and so on.