The prevention and management of iatrogenic major abdominal vascular injury.
Yang Wenqi,Meng Xiangling,Peng Cheng,et al.Dept. of General Surgery,First Affiliated Hospital,Anhui Medical University,Hefei 230022,China
Objective To investigate the common causes of iatrogenic major abdominal vascular injuries and to clarify its possible prevention and management measures.Methods A retrospective study of 20 patients with iatrogenic major abdominal vascular injuries from 1985 to 1999 was performed.Results Most injuries(n=18)involved the vein system and were associated with radical operations of cancers in which the tumor was adjacent to the vessel;the injuries involved abdominal aorta(n=2)、inferior vena cava(n=6)、portal vein(n=3)、superior mesenteric vein(n=3)、external iliac vein(n=2)、internal iliac vein(n=3)、renal vein(n=1)and consisted of single rupture(n=11)、multiple rupture(n=1)、blunt tear(n=6)、transection(n=1)and segmental transection(n=1);the repair techniques included suture a blood vessel、end-to-end anastomosis、autologous vein grafting、autologous peritoneal patch and ligation;the overall mortality of the series was 35%.Conclusion Prevention is still the best treatment for iatrogenic major abdominal vascular injury and timely and adequate repair of the involving vessel is the key to survial and good outcome.
【CateGory Index】： R656