Applied Study Of Vascular Surgical Technique In Treatment Of Thoracic Tumor

Objective To investigate the appliance of vascular technique in surgical treatment , of thoracic tumor, enlarge the surgical indication, discuss the technique ,methods, prognosis in surgical treatment of lung cancer and mediastinal tumor by replacement of superior vena cava and anonymous veins with vascular prosthesis. Methods Experimental research: two random groups A and B (each has 9 adult mongrel dogs). Group A was obstructed only , group B was replaced for SVC with vascular prosthesis. To measure the SVC pressure, analysis the strategies of anticoagulation and observe the pathological alteration of postoperative SVC and brain tissue. Clinical research: 56 patients with thoracic tumor, lung cancer were hi 42 , mediastinal tumor in 14 , males of 41 , females of 15 Age from 23 to 72, average 63.8, radiophotography reveal that SVC was invaded in 40 cases ,different extent obstruction of SVC in 38 cases, central carcinoma in 35 cases ,peripheral lung carcinoma 7 cases, thymus tumor in 11 cases, lymphoma 2 cases, lipoma recrudescence 1 case. All underwent resection of primary lesion and metastatic node combined with replacement for SVC. Non-system anticoagulation and long-term Follow-up was performed. Results experimental research show that the pressure of SVC and azygous vein blocked simultaneously were higher than SVC blocked only(p<0.05).The inner face of vascular prosthesis was covered with fibrin. Two months after operation, it turned into smooth fibrous membrane. And endotheliocyte can also be found to grow in it.. Thrombosis was not occurred without anticoagulation. Bloodshot and dropsy of brain tissue was not observed in two-hour obstruction.cavity of arachnoid bloodshot were found under microscope Clinic research reveal that total cases have not perioperative and postoperative early death and early or late obstruction of SVC and anonymous veins. Follow-up was performed in 38 cases in lung cancer groupe The overall survival rates at 1, 3 and 5 years were respectively 84.6%(32/38) 38.8%(9/22) and 36.3%(7/18).The 13 patients of raediastinal tumor are all lived and 1 patient with lipoma died of multimetastases in 8 months postoperation. Conclusions Azygous vena is a important branch communicated with SVC and IVC. anticoagulation is not necessary for these patients after operation. This surgical technique enlarged the indication of thoracic tumor, increased survival rate of advanced lung carcinoma. This method can ensure more radical resection of thoracic tumor, maximize preservation of living quality for patients. It may be recommended to application.