Temporary caval occlusion technique during right divisional hepatectomy for massive hepatocellular carcinoma with caudal vena cava compression/involvement in dogs.

TCO-assisted right divisional hepatectomy safely manages massive HCC with caval involvement in dogs.

This retrospective case series describes the use of temporary caval occlusion (TCO) during right divisional hepatectomy in 19 dogs with massive hepatocellular carcinoma involving or compressing the caudal vena cava (CVC). The TCO technique enabled controlled venous dissection with median occlusion duration of 17.6 minutes and median operative time of 82 minutes. R0 resection was achieved in 14 of 19 cases. One perioperative death occurred; 18 dogs were discharged, with six experiencing postoperative complications. Long-term follow-up showed seven dogs alive without recurrence (95-1355 days postoperatively) and 11 deaths at median postoperative day 729. The technique proved effective for managing right-sided HCC with caval involvement, allowing safe dissection of hepatic veins and repair of caval defects when necessary. TCO-assisted hepatectomy appears to be a viable surgical approach for this challenging tumor presentation in dogs, providing adequate oncologic control with acceptable perioperative morbidity and mortality.

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