Please cite this article in press as: Nigri G, et al. Inferior vena cava resection without prosthesis replacement for vena cava sarcoma (with video). Journal of Visceral Surgery (2016), http://dx.doi.org/10.1016/j.jviscsurg.2016.06.002 ARTICLE IN PRESS +Model JVS-612; No. of Pages 2 Journal of Visceral Surgery (2016) xxx, xxx—xxx Available online at ScienceDirect www.sciencedirect.com VISCERAL SURGERY VIDEOS Inferior vena cava resection without prosthesis replacement for vena cava sarcoma (with video) G. Nigri , N. Petrucciani ∗ , D. Sirimarco , L. Mangogna , P. Aurello , F. D’Angelo , G. Ramacciato Sapienza University, St Andrea Hospital, Department of Medical and Surgical Sciences and Traslational Medicine, UOC Chirurgia 3, Rome, Italy KEYWORDS Inferior vena cava; Surgery; Sarcoma; Leiomyosarcoma; IVC; Video In this video, we present a case of inferior vena cava (IVC) sarcoma with massive bilat- eral venous iliac thrombosis managed with caval resection and ligation of the IVC without replacement. Primary leiomyosarcomas of the IVC are rare tumors originating from smooth muscles localized in vena cava wall [1—3]. Surgical resection represents the main treat- ment for IVC sarcomas. As reported by Wachtel and al. [1], IVC replacement with prosthetic graft is the most frequent procedure (49.2% of cases), whereas ligation of the IVC without replacement has been observed in 20.3% of patients and primarily repair in 21.9%. A 45-years-old woman presented with bilateral lower limbs edema. The patient had no comorbidities and blood exams were normal. Abdominal CT-scan revealed a voluminous retroperitoneal mass of 11.5 × 7.5 cm, richly vascularized with spot of necrosis, located in the right flank, infiltrating the right kidney, causing renal pelvis expansion and right renal vein compression (Fig. 1). The mass infiltrated the IVC, from the convergence of the iliac veins to the ostium of the left renal vein. Thrombosis of the right common, internal and external iliac veins and thrombosis of the right femoral veins were also observed. Anticoagulant treatment with heparin was started. At laparotomy, Kocher’s maneuver was performed to free the duodenum, strictly adher- ent to the mass. The right liver was mobilized and the subhepatic vena cava was exposed. The right renal arteries and infrarenal aorta, which appeared medially rotated, were dissected. Iliac arteries and veins were isolated. We proceeded with ligature and section ∗ Corresponding author. Sant’Andrea Hospital, via di Grottarossa 1035, 00136 Rome, Italy. Tel.: +330 663 130 995. E-mail address: nicpetrucciani@hotmail.it (N. Petrucciani). http://dx.doi.org/10.1016/j.jviscsurg.2016.06.002 1878-7886/© 2016 Elsevier Masson SAS. All rights reserved.