在前切除期间发生的灾难性阴性腹部大动脉出血
Marion Head1, Ruwan Fonseka2, Anil Lala1
1General Surgery, Betsi Cadwaladr University Health Board, Bangor, UK.
BMJ case reports
|January 19, 2025
概括
这份案例报告强调了一个复杂的手术案例,涉及在腹腔镜手术过程中严重的血管损伤. 迅速转换为开放性手术和专家血管干预对于患者的生存和康复至关重要.
科学领域:
- 手术瘤学手术瘤学
- 血管外科 血管外科
- 胃肠道手术 胃肠道手术
背景情况:
- 一名70岁的女性患有高血压,乳腺癌和分泌腺瘤,接受了管状形腺瘤的手术.
- 这项手术涉及腹腔镜前切除,该手术因血管损伤而转换为开放的哈特曼手术,带有大动脉-双叶旁路.
研究的目的:
- 在结直肠外科手术期间报告一个具有挑战性的手术内血管损伤病例.
- 强调及时手术转换和血管团队参与的关键作用.
- 突出了手术前评估血管化的重要性.
主要方法:
- 对于管状状腺瘤的腹腔镜前切除.
- 转换为开放的哈特曼手术,在术内大动脉损伤后进行大动脉双绕道.
- 术后并发症的管理,包括双边形动脉栓塞和半腹.
主要成果:
- 成功管理严重的血管损伤,需要大动脉旁路和血管干预.
- 术后并发症的解决,包括栓塞事件和形成.
- 患者的康复没有癌症复发的证据.
结论:
- 早期转换为腹腔切除术对于管理重大手术内血管损伤至关重要.
- 在接受重大手术的老年患者中,对血管化进行术前评估是必不可少的.
- 包括血管外科手术在内的多学科合作是管理复杂外科并发症的关键.
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