Fig1

Typical preoperative and intraoperative images for right filled-type tumor thrombus. A Abdominal enhanced MRI showed right renal cell carcinoma(RCC) with filled-type tumor thrombus (RFTT). The tumor thrombus invaded the left and right wall of inferior vena cava.The extent of IVC involvement was about 12 cm. B In open surgery, the left renal vein, the distal end and the proximal end of inferior vena cava were fully exposed. C The distal end, the proximal end of the inferior vena cava and the left renal vein were transected separately. The distal end of the tumor thrombus was complicated with bland thrombus. D The distal stump of inferior vena cava was sutured with 4–0 Prolene suture. E Segmental resection of the inferior vena cava was used. The distal end, the proximal end of the inferior vena cava and the left renal vein were transected separately and the vascular stumps were sutured with 4–0 Prolene suture. F The surgical specimens showed the involved inferior vena cava has been segmental resected with the tumor thrombus inside. G The right kidney was incised to show a yellowish brown renal tumor inside