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Renal cell carcinoma with inferior vena cava (IVC) thrombosis is a rare disease with a poor prognosis without surgical treatment. The presence of a tumor thrombus in the cavity of the main vessel in most cases is accompanied by massive bleeding during thrombectomy. To reduce the volume of blood loss, it is possible to use cardiopulmonary bypassto reduce the potential risks associated with blood loss and unstable hemodynamics. Sometimes tumor thrombosis can be growth into the vein wall or lead to occlusion IVC, we consider that it’s indication for resection of the IVC. Thrombectomy with laparotomy access can be performed even with type IV tumor thrombosis, if the thrombus is not fixed to the wall of the suprarenal IVC and surgeon have enough view of suprarenal segment.This article presents a variant of surgical treatment of patients with right kidney cancer, type IV IVC thrombosis, occlusion infrarenal IVC and ileofemoral thrombosis. In both cases we made resection IVC – infrarenal segment in first case and suprarenal segment in second case.