Korean J Thorac Cardiovasc Surg.  2010 Jun;43(3):273-279. 10.5090/kjtcs.2010.43.3.273.

Superior Vena Cava Resection and Reconstruction in Thoracic Malignancy

• Han KN
• Kang CH
• Kim YT
• Jheon S
• Sung SW
• Kim JH

• KMID: 1455497
• DOI: http://doi.org/10.5090/kjtcs.2010.43.3.273

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.

Keyword

Lung neoplasms; Mediastinal neoplasms; Great vessels

MeSH Terms

Angioplasty
Brachiocephalic Veins
Constriction
Female
Heart Atria
Humans
Lung Neoplasms
Male
Mediastinal Neoplasms
Polytetrafluoroethylene
Recurrence
Transplants
Vena Cava, Superior
Polytetrafluoroethylene