Evaluating vertebral artery dominancy before T4 lung cancer surgery requiring subclavian artery reconstruction.
Surg Today
; 48(2): 158-166, 2018 Feb.
Article
em En
| MEDLINE
| ID: mdl-28770339
ABSTRACT
PURPOSES:
To evaluate vertebral artery (VA) dominancy and the risk of brain infarction in T4 lung cancer patients with tumor invasion into the subclavian artery.METHODS:
We reconstructed the subclavian artery in 10 patients with T4 non-small cell lung cancer. The histological stages were IIIA in eight patients and IIIB in two patients. We evaluated the VA dominancy by performing a four-vessel study preoperatively and investigated the relationship between the methods of VA treatment and postoperative brain complications, retrospectively.RESULTS:
Seven patients had a superior sulcus tumor (SST) and three had direct invasion into the mediastinum. Based on the tumor location, a transmanublial approach was used in five patients and a posterolateral hook incision was used in the other five. All subclavian artery (SA) reconstructions were done using an artificial woven graft. Preoperative angiography of the VA revealed poor development of the contralateral side in two patients. One of these patients suffered a severe brain infarction on postoperative day 2, which proved fatal. In the other patient, the VA was connected to the left SA graft by a side-to-end anastomosis and there was no postoperative brain complication.CONCLUSIONS:
Preoperative SA and VA angiography is mandatory for identifying the need for VA reconstruction in lung cancer patients with major arterial invasion.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Contexto em Saúde:
1_ASSA2030
/
2_ODS3
Problema de saúde:
1_doencas_nao_transmissiveis
/
2_muertes_prematuras_enfermedades_notrasmisibles
Assunto principal:
Artéria Subclávia
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Procedimentos Cirúrgicos Vasculares
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Artéria Vertebral
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Carcinoma Pulmonar de Células não Pequenas
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Neoplasias Vasculares
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Procedimentos de Cirurgia Plástica
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Neoplasias Pulmonares
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Surg Today
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Japão