Superior vena cava resection without venous reconstruction for thymic tumors: a report of two cases.

Background: Venous reconstruction is required in patients with superior vena cava (SVC) resection to maintain sufficient blood flow to avoid severe complications such as cerebral edema. However, venous reconstruction might not be needed in selected patients with well-established collateral circulations under internal jugular vein pressure (IJVP) monitoring. Case Description: In November 2020, a 57-year-old female patient presented with an anterior mediastinal mass after B2 thymoma resection for 8 years. A core needle biopsy suggested recurrence of B2 thymoma. The patient received sequential chemoradiotherapy (SCRT) and had a partial response. She underwent median sternotomy in April 2021. A collateral vessel from left innominate vein was found to descend along the left side of aortic arch. IJVP was 29 cmH Conclusions: To our knowledge, this is the first successful attempt of SVC resection alone without venous reconstruction and we reported long-term results. SVC resection alone under the safe threshold of IJVP was feasible and safe in selected patients with abundant collateral circulations. Patients could benefit from less surgical trauma and be spared of anticoagulants after surgery.