Shimizu Nahoko, Tanaka Yugo, Kuroda Sanae, Nakamura Hayate, Matsumoto Gaku, Mitsui Suguru, Sakai Shuto, Minami Kazuhiro, Kimura Kenji, Okamoto Takeshi, Hokka Daisuke, Maniwa Yoshimasa
Division of Thoracic Surgery, Kobe University, Kobe, Japan.
Kyobu Geka. 2018 Dec;71(13):1077-1080.
A 21-year-old man was referred to our hospital because of an abnormal shadow on a routine chest radiogram. Enhanced computed tomography showed an 83×74 mm mass in the anterior mediastinum, with invasion of the superior vena cava (SVC). Surgical resection with sternotomy was performed. Intraoperative temporary bypass grafting with a 5-Fr catheter was performed between the right brachiocephalic vein and right atrium. The mediastinal tumor was resected with the SVC, and SVC reconstruction with a 16 mm expanded polytetrafluoroethylene graft was performed. The bypass stabilized intraoperative vital signs and enabled safe completion of the operation. The pathological diagnosis was seminoma. SVC replacement combined with temporary bypass using a small diameter catheter is technically feasible and safe.
一名21岁男性因常规胸部X线片上出现异常阴影而转诊至我院。增强计算机断层扫描显示前纵隔有一个83×74 mm的肿块，侵犯了上腔静脉（SVC）。遂行胸骨切开术进行手术切除。术中在右头臂静脉和右心房之间用一根5Fr导管进行了临时旁路移植。纵隔肿瘤与上腔静脉一并切除，并用16 mm的膨体聚四氟乙烯移植物进行上腔静脉重建。旁路移植稳定了术中生命体征，使手术得以安全完成。病理诊断为精原细胞瘤。使用小直径导管进行上腔静脉置换并结合临时旁路在技术上是可行且安全的。
