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[一例需要重建上腔静脉的前纵隔恶性淋巴瘤病例]

[A case of malignant lymphoma of anterior mediastinum requiring superior vena cava reconstruction].

作者信息

Nomori H, Nara S, Kobayashi R, Takahashi Y

机构信息

Department of Surgery, Saiseikai Central Hospital.

出版信息

Kyobu Geka. 1992 May;45(5):446-9.

PMID:1593820
Abstract

The patient was a 21-year-old female with malignant lymphoma of the anterior mediastinum, which was associated with superior vena cava (SVC) syndrome due to tumor invasion and tracheo-bronchial stenosis due to tumor compression. The bilateral brachio-cephalic vein and superior vena cava were resected with the tumor, and SVC reconstruction with a ringed expanded polytetrafluoroethylene (EPTFE) graft was performed between the right brachio-cephalic vein and SVC, and between the left brachio-cephalic vein and the right appendage. Postoperative anti-coagulant therapy was not performed. Postoperatively, SVC syndrome and the complaint of tracheo-bronchial stenosis disappeared promptly. Venography, which was performed 2 weeks postoperatively, presented patency between the right brachio-cephalic vein and SVC, but the graft between the left brachio-cephalic vein and the right appendage was obstructed. SVC reconstruction using a ringed EPTFE graft is considered to be significant for the improvement of resectability and the relief of clinical symptoms.

摘要

该患者为一名21岁女性,患有前纵隔恶性淋巴瘤,因肿瘤侵犯导致上腔静脉(SVC)综合征,因肿瘤压迫导致气管支气管狭窄。双侧头臂静脉和上腔静脉与肿瘤一并切除,在右头臂静脉和上腔静脉之间以及左头臂静脉和右附件之间用带环的膨体聚四氟乙烯(EPTFE)移植物进行上腔静脉重建。术后未进行抗凝治疗。术后,上腔静脉综合征及气管支气管狭窄的主诉迅速消失。术后2周进行的静脉造影显示右头臂静脉和上腔静脉之间通畅,但左头臂静脉和右附件之间的移植物阻塞。使用带环EPTFE移植物进行上腔静脉重建被认为对提高可切除性和缓解临床症状具有重要意义。

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