The clinical investigation of extracorporeal vein bypass during lobectomy combined with superior vena cava graft for lung cancer

Abstract

To evaluate the benefits of three methods of extracorporeal vein bypass from superior vena cava (SVC) to femoral vein during lobectomy and SVC graft in patients with lung cancer. Fifty-five cases selected from the patients with lung cancer who had undergone lobectomy combined with SVC graft by sortilege were divided into 3 groups: blood discarding group ( n =20), blood drainage group ( n =20) and extracorporeal bypass group ( n =15). The mean arterial pressure (MAP) and SVC pressure were continuously monitored during the SVC graft. Hemoglobin (Hb) was measured before and during the SVC clamping and after the SVC off clamping. During SVC clamping, the patients in extracorporeal bypass group had a significantly lower SVC pressure than blood discarding group and blood drainage group, and there were significant decreases in MAP and Hb and increase in blood loss in blood discarding group than the other two groups. All the patients underwent a smooth operation and safely returned to intensive care unit. None of them involved any neurologically injured signs and symptoms. Extracorporeal SVC bypass can maintain a very stable hemodynamics and low SVCP during SVC resection and artificial vessel graft, which is an avail of brain perfusion and blood saving.