Our case of primary leiomyosarcomas involved retrohepatic, suprarenal, and infrarenal inferior vena cava (IVC). Preoperative phlebography proved that there was adequate collateral circulation formed, which allowed us to achieve en bloc resection including segment I and II IVC without either extracorporeal circulation or prosthetic revascularization of the IVC and renal vessels. Our choice of en bloc resection including segment I and II IVC without extracorporeal circulation or prosthetic replacement of the vessels was justified as the patient had normal liver and kidney function after the operation.
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