Surgical approach to superior vena cava syndrome associated with malignant neoplasm: A narrative review

Abstract

Introduction: Superior vena cava syndrome (SVCS) is a rare pathology, associated in most cases with neoplasms of malignant origin; which in advanced stages represents a medical-oncological emergency that compromises the patient's life.

Purpose of the review: The objective of the review is to outline the role of the different surgical and percutaneous alternatives for the treatment of SVCS. We look for reports that include the best survival results for the different current treatments.

Recent findings: The medical literature describes treatments such as radiotherapy, chemotherapy, bypass, endovascular therapy and vascular reconstruction for the management of SVCS, however, not all respond with the same efficacy at the time of a vital emergency. by SVCS; this product of the intrinsic and extrinsic factors of the patient. Among the extrinsic factors, the social condition stands out, which becomes a challenge when carrying out an integral management of the patient in border cities, where the data that the doctor knows about the patient is limited or the patient does not have a previous diagnosis. to guide management.

Conclusions: The starting point of the treatment of the patient with SVCS consists in differentiating the emergency and the stability by means of the severity classification table. In emergent cases there are 2 alternatives: endovascular therapy and radiotherapy. The surgical approach with Baypass is contraindicated and the definitive treatment with vascular reconstruction with a prosthesis has advantages and disadvantages that must be defined individually considering the etiology of the associated cancer.