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Superior vena cava obstruction in ca bronchus: bronchoscopic and radiologic evaluation in Iraqi patient in baghdad teaching hospital

Author: 
Hamza AL Sabah, Ahmed Basher, M., Hussein Adnan Mohammed and Ali, S. Dawood
Subject Area: 
Health Sciences
Abstract: 

Superior vena cava syndrome (SVCS) is obstruction of blood flow through the superior vena cava (SVC). It is a medical emergency and most often manifests in patients with a malignant disease process within the thorax. A total of 286 patients (218 male and 68 female) were diagnosed with CA bronchus. 253case (192 male and 61female) with an age mean ± SD (62.00 ± 11.896), (29 nonsmoker, 203 smoker, 21 ex- smoker) were diagnosed without SVCO, and 33 case (26 male and 7 female) with an age mean ± SD (62.76 ± 9.959), (5 nonsmoker, 27 smoker and 1 ex- smoker) were diagnosed with SVCO and CA bronchus (primary and or metastatic). Pre-bronchoscopy sputum cytology investigation of cases, Post bronchoscopy sputum investigation of cases and bronchoscopic evaluation of cases was done as well as, also the pleural biopsies and or fine needle aspirate were studied when available during the course of investigation. Otherwise radiological study was done in form of CXR and CT scan of the chest with and without contrast and according we divide the site of the lesion as upper left, lower left, upper right, lower right and others. Our results showed the smoking status within SVCO cases was non-significant difference as the p value was (0.257). According to the site of pathology the results suggested there was highly significant difference regarding the site of pathology in association with SVCO and highest rate with right upper lesion P value was (0.000). Also we compared the results regarding the type of pathology, and the results showed highly significant difference statistically the highest incidence of SVCO was with squamous cell CA and the P value was (0.007). The prebronchoscopic sample was statically significant P value was (0.000), also the results of postbronchoscopic sample showed no significant according to statistical analysis, P value was (0.321) within SVCO cases. Otherwise, the finding of the lesion by bronchoscopy was highly significant as it was positive in all 33 cases of SVCO P value was (0.000). And outcome is studied in all 33 patient within one year to see their survival, within one year from 33 cases of SVCO 21 were died ,6 survive and 6 lots to be followed. In conclusion from data derived from this study we concluded that SVCO is not uncommon within cases of CA bronchus.

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