Kitada M, Kubo Y, Hirata S, Yatsuyanagi E, Nosaka T, Sugimoto S, Moriyama H, Koshigo S, Muraki S, Sasajima T
First Department of Surgery, Asahikawa Medical College, Japan.
Kyobu Geka. 1995 Nov;48(12):985-9; discussion 989-92.
Four patients underwent resection of mediastinal malignant tumors with invasion to the superior vena cava. Two patients had invasive thymoma, one seminoma, and one metastatic mediastinal lymph nodes of unknown origin. Prior to resection of the tumor, an ePTFE graft was anastomosed between the innominate vein and the right atrium to maintain the venous drainage from the brain and the upper extremities. In two patients, the superior vena cava was reconstructed by patch angioplasty after the tumor with a part of the vena cava was safely resected. One patient died of acute respiratory failure, but the other three are alive and well without any evidence of graft obstruction. This safe and useful method in order to prevent cerebral congestion during and after resection of the tumor.
4例纵隔恶性肿瘤侵犯上腔静脉的患者接受了手术切除。2例为侵袭性胸腺瘤,1例为精原细胞瘤,1例为来源不明的纵隔转移性淋巴结。在肿瘤切除前,将一段人工血管在无名静脉和右心房之间进行吻合,以维持脑部和上肢的静脉引流。2例患者在安全切除部分上腔静脉肿瘤后,通过补片血管成形术重建上腔静脉。1例患者死于急性呼吸衰竭,但其他3例患者存活且情况良好,无人工血管梗阻迹象。这种方法安全且有用,可预防肿瘤切除期间及术后的脑充血。