Superior Vena Cava Resection and Reconstruction in Thoracic Malignancy.
10.5090/kjtcs.2010.43.3.273
- Author:
Kook Nam HAN
1
;
Chang Hyun KANG
;
Young Tae KIM
;
Sanghoon JHEON
;
Sook Whan SUNG
;
Joo Hyun KIM
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Korea. chkang@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Lung neoplasms;
Mediastinal neoplasms;
Great vessels
- MeSH:
Angioplasty;
Brachiocephalic Veins;
Constriction;
Female;
Heart Atria;
Humans;
Lung Neoplasms;
Male;
Mediastinal Neoplasms;
Polytetrafluoroethylene;
Recurrence;
Transplants;
Vena Cava, Superior
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2010;43(3):273-279
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The benefit of superior vena cava (SVC) resection in thoracic malignancies remains controversial. We analyzed the results of extended resection in patients with thoracic malignancy involving the SVC. MATERIAL AND METHOD: From March 2000 to March 2009, we performed surgical resection and reconstruction in 18 thoracic malignancies involving the SVC. Ten male and 8 female enrolled and their mean age was 56 years. RESULT: SVC reconstruction was performed in 9 patients with polytetrafluoroethylene (PTFE) graft. Primary closure was possible in 6 patients by partially clamping the SVC. Patch angioplasty was performed in 3 patients with PTFE or autologous pericardial patch. Three-year survival was 58.0% and median survival time was 24.5 months. Disease specific survival and recurrence free survival were not significantly different between lung cancer and mediastinal malignancy. Obstruction of graft was detected in 4 patients during follow-up; SVC graft obstruction in 1 patient, and accessory graft between the innominate vein and right atrium in 3 patients. CONCLUSION: Extended resection of thoracic malignancies involving the SVC was a feasible method in selected patients. Although the morbidity rate was relatively high, mid-term survival was acceptable when complete resection was possible.
