Surgical treatment of lung tumors with superior vena cava infiltration

Abstract

Introduction. Direct malignant invasion by primary lung tumors or by nodular metastases is the most frequent indication for superior vena cava resection and reconstruction. The aim of our work is to underline the importance of good evaluation and preoperative workup from the standpoint of the overall survival. Case outline. A male patient, aged 61 years, was admitted for the surgical treatment of adenocarcinoma of the right lung upper lobe. The proposed protocol for the treatment of our patient comprised radiological verification, biopsy with histopathology analysis, standard upper lobectomy with mediastinal lymphadenectomy and with resection of the superior vena cava in a length of about 30 mm. Reconstruction of the superior vena cava was done by implanting a 16 mm INTERGARD vascular graft, using the running suture. In our patient, grafting and bridging the superior vena cava structure prevented the development of postoperative vascular complications and improved survival from the beginning of the treatment. Conclusion. Mixed thoracic and vascular surgical treatment reduces postoperative complications and improves survival.