Surgical Treatment of Tumor Etiology Superior Vena Cava Syndrome

Evgenii Gavrilov, Gennadiy Khubulava, Viktor Tarasov, Iliya Larin

MILITARY-MEDICAL ACADEMY, Saint -Petersburg, Russia

Date, time and location: 2018.05.26 08:30, Congress Hall, 2F–C

Abstract

Objective: Superior vena cava syndrome is a devastating complication of obstructive lesions compromising the superior vena cava an its branches. Most cases today are caused by malignant tumors. The most frequent are lung carcinoma.

Material and methods: Between 1995 and 2014 65 patients with superior vena cava syndrome underwent surgical treatment for thoracic tumors. In all cases the vena was restricted by a neoplastic sleeve. A vertical sternotomy was performed in mostly cases. Another patients received an associated right anterolateral thoracotomy to obtain good surgical exposure for tumor resection and grafting.

Results: A 12–18 mm diameter polytetrafluoroethylene graft was inserted in all cases. The tumor resection was radical in 39 (60%) cases and palliative in 26 (40%). All patients had immediate relief of obstruction after by-pass. Five patients alive without disease at now. Mediana morbidity 21 months. All prostheses were passable imposed under control ultrasound, CT studies performed in all patients after 6,12 months. Cases of pulmonary embolism was not.

Conclusion: Resection and prosthetic superior vena cava with malignancies of the chest cavity accompanied by long-term survival of patients with preserved patency imposed prostheses and the absence of PE.