Experiment of Safe Blocking Time of Superior Vena Cava during the Operation_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 ZHUDuo-jie ¹ , XIAOJia-rong ² , LINFeng ² , ZHANGJian-hua ¹ , WANGCheng ¹ , LIBin ¹ , JIANGPeng ¹

1. Department of Thoracic Surgery, the Second Affiliated Hospital, Lanzhou University, Lanzhou 730030, P.R.China;
2. Department of Thoracic Surgery, Guizhou Medcial University, Guiyang 550025, P.R.China;

Corresponding author：

ZHUDuo-jie, Email: 39216801@qq.com

Keywords：

Superior vena cava syndrome; Rabbit; Encephaledema; Blocking time

DOI：

10.7507/1007-4848.20160089

Video：

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Objective We modeled superior vena cava (SVC) occlusion in rabbits to observe the effect of different blocking time on brains. Method Forty rabbits were randomly divided into four groups. Group Ⅰ was set as a control group (n=10). Group Ⅱ was set as a 30 minutes SVC blocking time group (n=10). Group Ⅲ was set as a 60 minutes SVC blocking time group (n=10). And group Ⅳ was set as a 90 minutes SVC blocking time group (n=10). We detected the patho- logical and physiological changes in the course of the experiment. After the intervention, malondialdehyde (MDA) and superoxide dismutase (SOD) of brain tissue homogenate in each group were detected. Brain sections were stained with hematoxylin-eosin (HE). And we observed the edema and damage of brain tissue under the microscope. Results There was no obvious change on the content of MDA and SOD within 30 minutes interruption (P>0.05). When the blocking time was longer than 60 minutes, the content of MDA increased significantly (P<0.05) and the SOD decreased significantly (P<0.05). Compared to the group Ⅰ and the group Ⅱ, the brain water content in the group Ⅲ and the group Ⅳ with a interruption time above 60 minutes increased significantly. And under the microscope, the cell edema and damage induced by ischemia and hypoxia increased significantly. Conclusion The blocking time of SVC within 30 minutes is relatively safe. But there would be significant brain edema and neurocyte degeneration when the blocking time is more than 60 minutes.

Citation： ZHUDuo-jie, XIAOJia-rong, LINFeng, ZHANGJian-hua, WANGCheng, LIBin, JIANGPeng. Experiment of Safe Blocking Time of Superior Vena Cava during the Operation. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(4): 386-389. doi: 10.7507/1007-4848.20160089 Copy

1.	Hohloch K, Bertram N, Trumper L, et al. Superior vena cava syndrome caused by a malignant tumor: a retrospective single-center analysis of 124 cases. J Cancer Res Clin Oncol, 2014, 140(12): 2129-2134.
2.	Lepper PM, Ott SR, Hoppe H, et al. Superior vena cava syndrome in thoracic malignancies. Respir Care, 2011, 56(5): 653-666.
3.	Pires NF, Morais A, Queiroga H. Superior vena cava syndrome as tumour presentation. Rev Port Pneumol, 2010, 16(1): 73-88.
4.	Urayama H, Kawase Y, Ohtake H, et al. Physiological changes during acute obstruction of the superior vena cava, azygos, and internal thoracic veins in dogs. J Cardiovasc Surg (Torino), 1997, 38(1): 87-92.
5.	Trigaux J, Lacrosse M, Daube A. Venous return by the paraumbilical and hepatic veins in case of superior vena cava obstruction. Abdom Imaging, 1996, 21(6): 504-506.
6.	张宜明, 于长海, 李捷, 等. 侵犯心脏大血管局部晚期肺癌的外科治疗. 中国胸心血管外科临床杂志, 2010, 17(5): 410-412.
7.	Halkic N, Henchoz L, Gintzburger D, et al. Superior vena cava syndrome caused by invasive epidermoid carcinoma. J Cardiovasc Surg (Torino), 2000, 41(3): 499-501.
8.	Shargall Y, de Perrot M, Keshavjee S, et al. 15 years single center experience with surgical resection of the superior vena cava for non-small cell lung cancer. Lung Cancer, 2004, 45(3): 357-363.
9.	Spaggiari L, Leo F, Veronesi G, et al. Superior vena cava resection for lung and mediastinal malignancies: a single-center experience with 70 cases. Ann Thorac Surg, 2007, 83(1): 223-230.
10.	马国伟, 傅剑华, 王进峰, 等. 上腔静脉回流无阻断人工血管置换术在肺癌外科中的应用. 中华胸心血管外科杂志, 2012, 28(12): 749-750.
11.	梁超, 洪志鹏. 胸部肿瘤引起上腔静脉综合征的治疗及进展. 中华肺部疾病杂志（电子版）, 2011, 04(2): 143-147.
12.	彭忠民, 陈景寒, 孟龙, 等. 肺癌累及上腔静脉的外科治疗. 中华外科杂志, 2006, 44(6): 402-404.
13.	Durkovic S, Di Chiara F, Rea F. Prosthetic azygo-atrial bypass for palliation of superior vena cava syndrome. Eur J Cardiothorac Surg, 2012, 41(4): e56-58.
14.	刘斌, 潘莉, 王雄, 等. 肺切除合并上腔静脉切除人造血管置换术治疗上腔静脉综合征的麻醉处理. 中国肺癌杂志, 2003, 6(6): 492-494.
15.	Singh S, Sherif H, Reul GJ. Reconstruction of the superior vena cava with the aid of an extraluminal venovenous jugulo-atrial shunt. Tex Heart Inst J, 2000, 27(1): 38-42.
16.	Mayo Moldes M, Tur Alonso A, Serrano Martinez F, et al. Anesthesia for a patient with superior vena cava syndrome. Rev Esp Anestesiol Reanim, 2004, 51(2): 100-103.
17.	Vretzakis G, Didilis V, Dragoumanis C, et al. Non-programmed clamping of superior vena cava. The anesthesiologist's Achilles' heel. Acta Anaesthesiol Belg, 2006, 57(1): 59-62.
18.	宋兴荣, 胡方方, 丁以群, 等. 上腔静脉压剧增对幼犬脑损伤的影响. 热带医学杂志, 2007, 7(6): 558-559,562.
19.	李敏杰, 喻风雷, 唐剑锋. 兔急性上腔静脉梗阻的安全时限. 中华胸心血管外科杂志, 2008, 24(3): 192-194.
20.	Ito U, Ohno K, Nakamura R, et al. Brain edema during ischemia and after restoration of blood flow. Measurement of water, sodium, potassium content and plasma protein permeability. Stroke, 1979, 10(5): 542-547.

1. Hohloch K, Bertram N, Trumper L, et al. Superior vena cava syndrome caused by a malignant tumor: a retrospective single-center analysis of 124 cases. J Cancer Res Clin Oncol, 2014, 140(12): 2129-2134.
2. Lepper PM, Ott SR, Hoppe H, et al. Superior vena cava syndrome in thoracic malignancies. Respir Care, 2011, 56(5): 653-666.
3. Pires NF, Morais A, Queiroga H. Superior vena cava syndrome as tumour presentation. Rev Port Pneumol, 2010, 16(1): 73-88.
4. Urayama H, Kawase Y, Ohtake H, et al. Physiological changes during acute obstruction of the superior vena cava, azygos, and internal thoracic veins in dogs. J Cardiovasc Surg (Torino), 1997, 38(1): 87-92.
5. Trigaux J, Lacrosse M, Daube A. Venous return by the paraumbilical and hepatic veins in case of superior vena cava obstruction. Abdom Imaging, 1996, 21(6): 504-506.
6. 张宜明, 于长海, 李捷, 等. 侵犯心脏大血管局部晚期肺癌的外科治疗. 中国胸心血管外科临床杂志, 2010, 17(5): 410-412.
7. Halkic N, Henchoz L, Gintzburger D, et al. Superior vena cava syndrome caused by invasive epidermoid carcinoma. J Cardiovasc Surg (Torino), 2000, 41(3): 499-501.
8. Shargall Y, de Perrot M, Keshavjee S, et al. 15 years single center experience with surgical resection of the superior vena cava for non-small cell lung cancer. Lung Cancer, 2004, 45(3): 357-363.
9. Spaggiari L, Leo F, Veronesi G, et al. Superior vena cava resection for lung and mediastinal malignancies: a single-center experience with 70 cases. Ann Thorac Surg, 2007, 83(1): 223-230.
10. 马国伟, 傅剑华, 王进峰, 等. 上腔静脉回流无阻断人工血管置换术在肺癌外科中的应用. 中华胸心血管外科杂志, 2012, 28(12): 749-750.
11. 梁超, 洪志鹏. 胸部肿瘤引起上腔静脉综合征的治疗及进展. 中华肺部疾病杂志（电子版）, 2011, 04(2): 143-147.
12. 彭忠民, 陈景寒, 孟龙, 等. 肺癌累及上腔静脉的外科治疗. 中华外科杂志, 2006, 44(6): 402-404.
13. Durkovic S, Di Chiara F, Rea F. Prosthetic azygo-atrial bypass for palliation of superior vena cava syndrome. Eur J Cardiothorac Surg, 2012, 41(4): e56-58.
14. 刘斌, 潘莉, 王雄, 等. 肺切除合并上腔静脉切除人造血管置换术治疗上腔静脉综合征的麻醉处理. 中国肺癌杂志, 2003, 6(6): 492-494.
15. Singh S, Sherif H, Reul GJ. Reconstruction of the superior vena cava with the aid of an extraluminal venovenous jugulo-atrial shunt. Tex Heart Inst J, 2000, 27(1): 38-42.
16. Mayo Moldes M, Tur Alonso A, Serrano Martinez F, et al. Anesthesia for a patient with superior vena cava syndrome. Rev Esp Anestesiol Reanim, 2004, 51(2): 100-103.
17. Vretzakis G, Didilis V, Dragoumanis C, et al. Non-programmed clamping of superior vena cava. The anesthesiologist's Achilles' heel. Acta Anaesthesiol Belg, 2006, 57(1): 59-62.
18. 宋兴荣, 胡方方, 丁以群, 等. 上腔静脉压剧增对幼犬脑损伤的影响. 热带医学杂志, 2007, 7(6): 558-559,562.
19. 李敏杰, 喻风雷, 唐剑锋. 兔急性上腔静脉梗阻的安全时限. 中华胸心血管外科杂志, 2008, 24(3): 192-194.
20. Ito U, Ohno K, Nakamura R, et al. Brain edema during ischemia and after restoration of blood flow. Measurement of water, sodium, potassium content and plasma protein permeability. Stroke, 1979, 10(5): 542-547.

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