Surgical strategy for invasive pulmonary and mediastinal tumors require reconstruction of superior vena cava

Abstract

Objective: We present Thoracic surgical strategy in patients with invasive pulmonary and mediastinal tumors which required partial or complete resection and reconstruction of the superior vena cava (SVC).Material and Methods: For a period of 7 years, 15 operated patients aged 16 to 78 years. (Average 51.4 years). SVC syndrome was observed in 6 patients. Tumors of the anterior mediastinum were invasive thymoma - 5 patients; hemangiopericytoma in 1 patient, angiosarcoma in 1 patient. Pulmonary tumors were bronchogenic cancer , 7 and 1 in small cell carcinoma. In one patient was applied extracorporal circulatrion because existing fixed thrombus in the right atrium. Total reconstruction of the SVC done in 6 patients, axial resection for 2 persons and 4 persons make reconstruction of just the right subclavian vein and SVC. For vascular reconstruction we use autologous pericardium and autologous spiral vein graft .Results: The follow-up period of 6 years . up to 6 months. Early anonima vein thrombosis had 2 patients after reconstruction. One patient died 48 hours of total thrombosis of the cerebral veins. One patient with angiosarcoma died of meta 4 years after surgery. All patients with invasive thymoma are alive and present.Conclusions: The matched lung resection and reconstruction of the SVC are effective in patients with lung cancer about their survival. Total reconstruction of the SVC with autologous pericardium resection of mediastinal tumors with good survival and does not require continuous anticoagulant therapy.