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Lessons Learned From Treating 114 Inferior Vena Cava Injuries at a Limited Resources Environment - A Single Center Experience.
Góes Junior, Adenauer Marinho de Oliveira; Silva, Karlene Thayane Barros da; Furlaneto, Ismari Perini; Abib, Simone de Campos Vieira.
Afiliação
  • Góes Junior AMO; Metropolitan Emergency Hospital, Almirante Barroso, Belém, PA, Brazil. Electronic address: adenauerjunior@gmail.com.
  • Silva KTBD; Metropolitan Emergency Hospital, Almirante Barroso, Belém, PA, Brazil.
  • Furlaneto IP; Metropolitan Emergency Hospital, Almirante Barroso, Belém, PA, Brazil.
  • Abib SCV; Metropolitan Emergency Hospital, Almirante Barroso, Belém, PA, Brazil.
Ann Vasc Surg ; 80: 158-169, 2022 Mar.
Article em En | MEDLINE | ID: mdl-34752854
BACKGROUND: The inferior vena cava is the most frequently injured vascular structure in penetrating abdominal trauma. We aimed to review inferior vena cava injury cases treated at a limited resources facility and to discuss the surgical management for such injures. METHODS: This was a retrospective study of patients with inferior vena cava injuries who were treated at a single center between January 2011 and January 2020. Data pertaining to the following were assessed: demographic parameters, hypovolemic shock at admission, the distance that the patient had to be transported to reach the hospital, affected anatomical segment, treatment, concomitant injuries, complications, and mortality. Non-parametric data were analyzed using Fisher's exact, Chi-square, Mann-Whitney, or Kruskal-Wallis test, as applicable. The Student's t-test was used to assess parametric data. Moreover, multiple logistic regression analyses (including data of possible death-related variables) were performed. Statistical significance was set at P <0.05. RESULTS: Among 114 patients with inferior vena cava injuries, 90.4% were male, and the majority were aged 20-29 years. Penetrating injuries accounted for 98.2% of the injuries, and the infrarenal segment was affected in 52.7% of the patients. Suturing was perfomed in 69.5% and cava ligation in 29.5% of the patients, and 1 patient with retrohepatic vena cava injury was managed non-operatively. The overall mortality was 52.6% with no case of compartment syndrome in the limbs. A total of 7.9% of the patients died during surgery. CONCLUSION: The inferior vena cava is often injured by penetrating mechanisms, and the most frequently affected segment was the infrarenal segment. A higher probability of death was not associated with injury to a specific anatomical segment. Additionally, cava ligation was not related to an increased probability of compartment syndrome in the leg; therefore, prophylactic fasciotomy was not supported.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Veia Cava Inferior / Ferimentos Penetrantes / Lesões do Sistema Vascular / Traumatismos Abdominais Tipo de estudo: Observational_studies Limite: Adolescent / Adult / Child / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: Ann Vasc Surg Assunto da revista: ANGIOLOGIA Ano de publicação: 2022 Tipo de documento: Article País de publicação: Holanda

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Veia Cava Inferior / Ferimentos Penetrantes / Lesões do Sistema Vascular / Traumatismos Abdominais Tipo de estudo: Observational_studies Limite: Adolescent / Adult / Child / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: Ann Vasc Surg Assunto da revista: ANGIOLOGIA Ano de publicação: 2022 Tipo de documento: Article País de publicação: Holanda