累及无名静脉和上腔静脉的复发胸腺神经内分泌肿瘤手术麻醉管理一例报告

Anesthetic management for resection of recurrent thymic neuroendocrine tumor involving the brachiocephalic vein and superior vena cava:A case report

目的报告一例累及无名静脉和上腔静脉的复发胸腺神经内分泌肿瘤患者行肿瘤切除术的系统麻醉管理流程。方法胸腺肿瘤累及无名静脉和上腔静脉,手术及麻醉风险大,术中静脉压迫以及血管置换,可引起静脉回流受阻,严重可导致上腔静脉综合征,影响患者术后转归。本病例术前系统制定手术麻醉方案,术中密切关注手术进程,外科医生和麻醉医生密切配合,术中输液精细化管理及持续精准监测静脉压力等方法,充分保障了患者的手术麻醉安全。结果患者术中平稳,无严重并发症,术后顺利康复出院。结论该类病例重点在于预防术中静脉回流受阻引起的相关并发症。本病例的成功管理经验对后续类似疾病的手术麻醉处理具有指导意义。

Objective To report the anesthetic management during the surgical resection of a recurrent thymic neuroendocrine tumor involving the brachiocephalic vein and superior vena cava(SVC).Methods The thymic tumor’s involvement with the brachiocephalic vein and SVC poses significant surgical and anesthetic risks,including potential venous obstruction and superior vena cava syndrome(SVCS).A comprehensive preoperative anesthetic plan was developed,with close intraoperative monitoring and collaboration between surgeons and anesthesiologists.Precision fluid management and continuous venous pressure monitoring ensured patient safety.Results The patient remained stable during surgery,had no major complications,and was discharged after a smooth recovery.Conclusion Effective management focuses on preventing complications from impaired venous return.This case offers valuable insights for anesthetic management in similar situations.