[Surgical treatment of superior vena cava syndrome]

Thirty-seven patients with superior vena cava (SVC) syndrome were admitted to our hospital during the recent six years. Among them, 23 were treated surgically. The approaches we used included SVC-atrial shunt plus lesion resection (1), innominate-atrial shunt without (2) or with membranotomy (1), jugular-atrial shunt (1), azygous-atrial shunt plus meso-atrial shunt (1), jugular-saphenous shunt (8), omental neck transplantation substernally (4) including one with omental-cervical vein anastomosis, and so on. Follow-up for an average of 40 months, showed marked effect in 55% of the surgical cases, improvement in 30%, and death in 10%. It is suggested to select intrathoracic operations for young, good risk, and surgically resectable patients and saphenous transplantation for elder, high risk and unresectable patients.