[Surgical treatment of superior vena cava syndrome].

OBJECTIVE

To analyze the clinical features, especially surgical treatment of superior vena cava syndrome (SVCS).

METHODS

The clinical data of 26 patients with SVCS, 19 males and 7 females, aged 37 (19-63), diagnosed base on the space occupying lesion in mediastinum and complete or incomplete obstruction of SVC and/or innominate vein by imaging examination without evidence of tumor in other parts and without evidence of lymphoma in the mediastinal lesion by pathological examination, who underwent surgical treatment were analyzed, focusing on the clinical presentation, preoperative examination, surgical treatment, pathological diagnosis, and survival.

RESULTS

Facial cyanosis and edema, cervical and chest wall varicose veins, headache and dizziness, cough and dyspnea were the most common clinical manifestations. Pre-operative percutaneous needle biopsy guided by CT confirmed the diagnoses of malignant tumor of mediastinum in 6 cases and definite diagnoses failed to be got in the other 20 cases. Resection of the primary lesions combined with artificial blood vessel replacement of SVC was performed. Twenty patients received complete resection, and 6 received only incomplete excision because of extensiveness of lesions. The mean survival time of the former group was 30 months, significantly longer than that of the latter group (11 months, P = 0.0036). The overall 1-year survival rate was 69.2%, and 5-year survival rate was 7.6%.

CONCLUSION

Resection procedure is an important factor influencing the prognosis of SVCS.