V-112
TOTAL SUPERIOR VENA CAVA RESECTION COMBINED WITH TRACHEAL RESECTION FOR PRIMARY LUNG CANCER

Objectives: Surgery for T4 lung cancer remains challenging. Here, we present a surgical case of primary lung cancer invading the mediastinum with combined resection and reconstruction of the entire superior vena cava (SVC) and trachea.

Video description: A 44-year-old man was referred with the diagnosis of clinical stage IIIA (T4N0M0) lung adenocarcinoma originating from the right upper lobe, invading the entire portion of the SVC and its branches including the right brachiocephalic vein, right subclavian vein and internal jugular vein. Through a combined approach of median sternotomy with transmanubrial approach, en bloc resection of the right upper lobe and involved mediastinal structures including the SVC and its branches (the right brachiocephalic vein, right subclavian vein, internal jugular vein and azygous vein) was achieved; SVC and its branches were reconstructed with ePTEF conduits. Three rings of trachea were also resected and reconstructed, because tracheal invasion was identified intraoperatively.

Conclusion: Complete resection for “double T4” lung cancer was achieved with combined resection of the SVC and trachea.

Disclosure: No significant relationships.