Erkan KABA, Mehmet Oğuzhan ÖZYURTKAN, Berker ÖZKAN, Kemal AYALP, Alper TOKER

Mediasten tümörleri ve benign hastalıklarında süperior vena kava rezeksiyon ve rekonstrüksiyonu

Amaç: Bu çalışmada mediasten tümörlerinin ve benign hastalıklarının invaze ettiği süperior vena kava rezeksiyonu ve rekonstrüksiyonu sonuçlarımız değerlendirildi. Çalışma planı: Eylül 2006 - Eylül 2016 tarihleri arasında mediasten patolojileri nedeniyle superior vena kava rezeksiyonu ve rekonstrüksiyonu uygulanan 17 hasta (8 erkek, 9 kadın; ort. yaş 46±17 yıl; dağılım 9-74 yıl) retrospektif olarak incelendi. Primer sütür ile anjiyoplasti veya stapler ile parsiyel rezeksiyon yapılan hastalar elendi. Demografik ve ameliyat sırası ve sonrası ölçümlere dayanılarak mortalite ve morbidite oranları analiz edildi. Bulgular: Hastaların çoğunda (%94) mediasten tümörü vardı. On iki hastada (%71) timik epitelyal tümör vardı. Dokuz hastada (%53) ringli politetrafloroetilen protez kullanılarak tübüler greft interpozisyonu, sekiz hastada (%47) ise otolog perikard, politetrafloroetilen veya Dacron greftler kullanılarak yama plasti uygulandı. On bir hastada (%65) komşu organlarda eşlik eden rezeksiyon gerekti. Ortalama hastanede yatış süresi 11±6 gündü. Ameliyat sırası ölüm olmadı. Üç hastada (%18) mortalite gerçekleşti. Beş hastada (%29) komplikasyon gelişti. Mortalite yaşlı hastalarda daha sık gerçekleşti (p

Superior vena cava resection and reconstruction in mediastinal tumors and benign diseases

Background: This study aims to evaluate our results of resection and reconstruction of the superior vena cava invaded by mediastinal tumors and benign diseases.Methods: Seventeen patients (8 males, 9 females; mean age 46±17 years; range 9 to 74 years) undergoing superior vena cava resection and reconstruction due to mediastinal pathologies between September 2006 and September 2016 were retrospectively reviewed. Patients who had angioplasty with primary suturing or partial resection with stapler were excluded. Mortality and morbidity rates were analyzed based on the demographic, and intra- and postoperative measures.Results: Majority of patients (94%) had mediastinal tumors. Twelve patients (71%) had thymic epithelial tumors. Tubular graft interposition was performed using ringed polytetrafluoroethylene prosthesis in nine patients (53%), while patch plasty using autologous pericardium, polytetrafluoroethylene or Dacron grafts was performed in eight patients (47%). Eleven patients (65%) necessitated concomitant resections of neighboring structures. Mean length of hospital stay was 11±6 days. There was no intraoperative death. Mortality occurred in three patients (18%). Five patients (29%) developed complications. Mortality occurred commonly in elderly patients (p

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