上大静脈上部を巻き込む肺癌に対する血管横断グラフト再建術

We report a patient with a case of lung cancer invading the right brachiocephalic vein (BCV) and superior vena cava (SVC) that was managed with single prosthetic graft reconstruction. A 63-year-old patient with stage IIIA squamous cell carcinoma underwent right upper and middle lobectomy, rib resection, and vascular reconstruction after neoadjuvant chemoradiotherapy. The right BCV was clamped and transected, and the SVC was stapled obliquely at its bifurcation. A polytetrafluoroethylene graft was interposed from the right BCV to the right atrium, preserving SVC flow without cross-clamping. This technique minimized hemodynamic instability and reduced the risk of graft occlusion in tumors involving the upper SVC.