Abstract
Five resected cases of invasive superior and anterior mediastinal tumors with superior vena caval (SVC) reconstruction using expanded polytetrafluroethylene (EPTFE) grafts were reported. Tumor extirpations were successfully carried out with combined resection of great veins, lung, pericardium, phrenic nerve, vagal nerve and so on, and reconstruction of SVC with EPTFE graft was performed. Modalities of reconstruction were as follows; one graft between the left brachiocephalic vein and right appendage and another graft between the right brachiocephalic vein and SVC in 3 cases, I graft between the left brachiocepohalic vein and right appendage and SVC patch in one case, and 1 graft between left brachiocephalic vein and SVC in one case. Excellent long patency was maintained in grafts with external ring support anastmosed between the brachiocephalic vein and SVC. The case with germ cell tumor is free of disease 16 months postoperatively, who is the longest survivor in this study.
In conclusion, reconstruction of SVC using EPTFE graft is considered to be significant for the improvement of resectability, the relief of clinical symptoms and the extension of surgical indication in invasive superior and anterior mediastinal neoplasms.
