Umeda Yukio, Matsumoto Shinsuke, Mori Yoshio, Takiya Hiroshi
Department of Cardiothoracic Surgery, Gifu Prefectural General Medical Center, Gifu, Japan.
Kyobu Geka. 2014 Sep;67(10):873-6.
A 63-year-old man was referred to our department for surgical resection of invasive thymoma (type B3)after 2 courses of chemo-therapy resulted in stable disease. Resection of the tumor was done through a median sternotomy under monitoring of regional cerebral saturation of oxygen (rSo2) using near-infrared spectroscopy (NIRS). The tumor invaded to the right upper lobe (S3), the right phrenic nerve, the superior vena cava (SVC), and the bilateral brachiocephalic vein (BCV). Although bilateral clamping of the BCVs induced significant decrease in rSo2, unilateral clamping of the BCV did not. Therefore, reconstruction of the SVC by sequential reconstruction of BCVs was carried out, and the tumor was successfully and safely excised with the SVC and a part of the right upper lobe.
一名63岁男性在接受2个疗程化疗后病情稳定，被转诊至我科接受侵袭性胸腺瘤（B3型）的手术切除。在使用近红外光谱（NIRS）监测局部脑氧饱和度（rSo2）的情况下，通过正中胸骨切开术切除肿瘤。肿瘤侵犯右上叶（S3）、右膈神经、上腔静脉（SVC）和双侧头臂静脉（BCV）。尽管双侧夹闭BCV会导致rSo2显著下降，但单侧夹闭BCV则不会。因此，通过依次重建BCV进行了SVC重建，肿瘤与SVC及右上叶的一部分被成功、安全地切除。
