Mediastinoscopy as an Emergency Diagnostic Procedure in Superior Vena Cava Syndrome

Callejas, M.A.; Rami, R.; Catalán, Miguel; Mainer, Ana; Sánchez-Lloret, Juan

doi:10.3109/14017439109098098

Cited by 18 publications

(3 citation statements)

References 5 publications

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“…Kirschner [34] performed mediastinoscopy in 16 patients with SVCS without complication. Callejas et al [35] reported one wound infection and one carotid artery injury in eight such cases. Little et al [36] had no complications in eight patients who underwent cervical mediastinoscopy.…”

Section: Treatmentmentioning

confidence: 98%

Superior vena cava syndrome

Wudel

Nesbitt

2001

Curr. Treat. Options in Oncol.

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Lung cancer is the most common cause of superior vena cava syndrome (SVCS) and requires timely recognition and management. The syndrome is rarely an oncologic emergency in the absence of tracheal compression and airway compromise. Treatment depends on the etiology of the obstructive process. Treatment should also be individualized and should not be undertaken until a diagnosis is obtained. Most patients with SVCS secondary to lung cancer can be treated with appropriately directed chemotherapy or radiotherapy. With the refinement of endovascular stents, percutaneous stenting of the SVC is being increasingly used as primary treatment modality. Thrombotic occlusion can be treated with appropriate lytic agents. In rare circumstances, surgical decompression can be performed; bypass or replacement of the SVC results in immediate improvement in the majority of cases and can be accomplished with low morbidity.

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Section: Treatmentmentioning

confidence: 98%

Superior vena cava syndrome

Wudel

Nesbitt

2001

Curr. Treat. Options in Oncol.

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“…Tanı koyma başarısı %90 ve %100'lere ulaşır (12,13). Kanama ve enfeksiyon gibi risk oranı %0-7'dir (14,15). h) Endobronşiyal Ultrasonografik Biyopsi (EBUS) VKSS'lu hastalarda EBUS kullanımı ile ilgili bir bilgi şu an için yoktur.…”

Section: G) Mediastinoskopiunclassified

Vena Kava Superior Sendromu Ve Cerrahisi

Yıldızeli¹

2011

Toraks Cer Bult

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Vena Kava Superior Sendromu (VKSS) sıklıkla, lenfoma ve akciğer kanseri gibi malignansilerin bir komplikasyonudur. VKSS sıklığı alta yatan malignansiye göre değişmekle beraber, akciğer kanseri hastalarının %2-4'ünde VKSS gelişebilir (1, 2). Küçük hücreli akciğer kanserinde bu oran %10'lara ulaşır.Vena Kava Superior Sendromu ilk olarak 1757'de William Hunter (1) tarafından sifilitik aortik anevrizmalı bir olguda tanımlanmıştır. Amerika Birleşik Devletlerinde yılda yaklaşık 15,000 vaka bildirilmektedir. Yetişkinlerin %95'inde neden primer intratorasik yada metastatik tümördür. Diğer yandan, santral venöz kateter ve 'pace maker' kullanımının artması ile benign etyolojiye bağlı VKSS olguları artmıştır. Çocuklarda, T-hücreli lösemi ve lenfoma VKKS'un en sık nedenlerdir.Bu yazıda vena kava superior sendromu kliniği ve tedavisi ile vena kava superior invazyonu yapan malign veya benign hastalıkların cerrahi tedavileri sunulmuştur.

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“…Operative endoscopy has gained a new significance in the evaluation of SVCS since echography has been introduced but the best diagnostic result is still obtained by the mediastinoscopy. Venous hypertension may increase the procedure-related risk [23][24][25][26][27].…”

Section: Diagnosismentioning

confidence: 99%

Superior Vena Cava Syndrome

Rafiński¹,

Szczepski²,

A³

et al.

Encyclopedia of Diagnostic Imaging

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The superior vena cava (SVC) originates in the chest, behind the first right sternocostal articulation, from the confluence of two main collector vessels: the right and left brachiocephalic veins which receive the ipsilateral internal jugular and subclavian veins. It is located in the anterior mediastinum, on the right side. The internal jugular vein collects the blood from head and deep sections of the neck while the subclavian vein, from the superior limbs, superior chest and superficial head and neck. Several other veins from the cervical region, chest wall and mediastinum are directly received by the brachiocephalic veins. After the brachiocephalic convergence, the SVC follows the right lateral margin of the sternum in an inferoposterior direction. It displays a mild internal concavity due to the adjacent ascending aorta. Finally, it enters the pericardium superiorly and flows into the right atrium; no valve divides the SVC from right atrium. The SVC's length ranges from 6 to 8 cm. Its diameter is usually 20-22 mm. The total diameters of both brachiocephalic veins are wider than the SVC's caliber. The blood pressure ranges from -5 to 5 mmHg and the flow is discontinuous depending on the heart pulse cycle. The SVC can be classified anatomically in two sections: extrapericardial and intrapericardial. The extrapericardial segment is contiguous to the sternum, ribs, right lobe of the thymus, connective tissue, right mediastinal pleura, trachea, right bronchus, lymphnodes and ascending aorta. In the intrapericardial segment, the SVC enters the right atrium on the upper right face of the heart; in front it is close to the right main pulmonary artery. On the right side, the lung is in its proximity, separated only by mediastinal pleura. The right phrenic nerve runs next to the SVC for its entire course [1] (Figure 1). The SVC receives a single affluent vein: the azygos vein. The azygos vein joins the SVC from the right side, at its mid length, above the right bronchus. The Azygos vein constantly receives the superior intercostal vein, a large vessel which drains blood from the upper two or three right intercostal spaces. In the case of SVC obstruction, the azygos vein is responsible for the most important collateral circulation. According to the expected collateral pathways, the SVC can be divided into two segments: the supra-azygos or www.intechopen.com

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Mediastinoscopy as an Emergency Diagnostic Procedure in Superior Vena Cava Syndrome

Cited by 18 publications

References 5 publications

Superior vena cava syndrome

Superior vena cava syndrome

Vena Kava Superior Sendromu Ve Cerrahisi

Superior Vena Cava Syndrome

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