Total superior vena cava reconstruction guided by preoperative three-dimensional (3D)-computed tomography bronchography and angiography

Abstract

Background: The treatment of superior vena cava syndrome caused by invasive thymoma is challenging. This paper aims to explore the application of preoperative three-dimensional computed tomography bronchography and angiography (3D-CTBA) for total superior vena cava reconstruction.Methods: Total superior vena cava reconstruction guided by preoperative 3D-CTBA in the treatment of superior vena cava syndrome offers more accurate surgical evaluation and more effective procedure of multidisciplinary team (MDT), assists radical dissection and vascular reconstruction as planed in the way of "Step by Step". It also makes the follow-up procedure more effective.Results: High-quality thoracic computed tomography (CT) image is essential. A medical team ensures procedural success with 3D-CTBA. Using this approach, five patients have been treated successfully. The average operative length was 324 minutes and the average blood loss was 190 mL. There was no surgical mortality. Five patients are alive.Conclusions: Total superior vena cava reconstruction guided by preoperative 3D-CTBA is an effective technology for radical resection of mediastinal lesions combined with artificial vascular replacement.Meanwhile, 3D-CTBA improves the efficiency of MDT and surgical planning. It contributes to alleviate symptoms of SVCS and improve the quality of postoperative life.