VIDEO-ASSISTED THORACOSCOPIC RESECTION OF THE LEFT BRACHIOCEPHALIC AND SUPERIOR VENA CAVA FOR PRIMARY AND RECURRENT THYMIC TUMORS.

OBJECTIVE: To evaluate the technical feasibility, safety, and short-term outcomes of video-assisted thoracoscopic surgery (VATS) resections of the left brachiocephalic vein (LBCV) and superior vena cava (SVC) in patients with primary and recurrent anterior mediastinal tumors. MATERIAL AND METHODS: A retrospective analysis of 9 patients who underwent VATS resection of the LBCV and/or SVC for thymic tumors between 2015 and 2025 was performed. INCLUSION CRITERIA: tumor invasion into venous trunks. EXCLUSION CRITERIA: need for vascular grafting, invasion of more than one-third of the SVC circumference, tumor thrombosis, distant metastases (M1b). RESULTS: R0 resection was achieved in all cases. Median blood loss was 110 ml, operative time - 330 min, postoperative hospital stay - 4 days. Grade I complications occurred in 3 patients; no mortality was observed. Median follow-up was 24 months. Local recurrence at the resection site occurred in 1 case (after tangential LBCV resection), regional recurrence (pleural dissemination) - in 1 patient with initial stage IVa disease, distant metastases - in 2 patients with neuroendocrine tumors. CONCLUSION: In strictly selected patients with thymic tumors, VATS resection of major veins is technically feasible and associated with low morbidity. Tangential LBCV resection carries a risk of local recurrence; therefore, complete vein transection is preferable. Further studies are required to assess long-term outcomes.