Yamashita C, Nakamura K, Okada M, Ozawa S, Ishii N, Chihara H, Oobo H, Tsuji F, Tobe S
Kyobu Geka. 1989 Feb;42(2):129-34.
SVC syndrome is occurred by the occlusion or stenosis of the superior vena cava secondary to malignant mediastinal tumor. Up to this report, surgical intervention has been thought to be difficult. Recently, extent of the tumor has been diagnosed exactly by CT scan, NMR, and angiography. Several cases undergoing complete resection of the tumor with the technique of vascular surgery have been reported. During the past 10 years, we have experienced 21 cases of SVC syndrome. 16 patients had operations and 5 patients had radiation or chemotherapy. The methods of operations were as follows: complete resection of the tumor 1, complete resection of the tumor and reconstruction of SVC 2, subtotal resection of the tumor and reconstruction of SVC 2, bypass of SVC only 5, extra-anatomical bypass 3. PTFE grafts were placed between right subclavian vein and SVC or left subclavian vein and right atrium. Extra-anatomical bypass were placed between jugular vein and femoral vein. PTFE bypass graft provides effective treatment for SVC obstruction with immediate and long term relief of SVC syndrome.
上腔静脉综合征是由恶性纵隔肿瘤继发的上腔静脉阻塞或狭窄引起的。截至本报告，手术干预一直被认为很困难。最近，通过CT扫描、核磁共振成像和血管造影术能够准确诊断肿瘤范围。已有数例采用血管外科技术完整切除肿瘤的病例报道。在过去10年中，我们共收治21例上腔静脉综合征患者。16例患者接受了手术，5例患者接受了放疗或化疗。手术方法如下：单纯肿瘤完整切除1例，肿瘤完整切除并重建上腔静脉2例，肿瘤次全切除并重建上腔静脉2例，仅行上腔静脉旁路术5例，解剖外旁路术3例。聚四氟乙烯移植物置于右锁骨下静脉与上腔静脉之间或左锁骨下静脉与右心房之间。解剖外旁路置于颈静脉与股静脉之间。聚四氟乙烯旁路移植物为上腔静脉阻塞提供了有效的治疗方法，可立即并长期缓解上腔静脉综合征。
