Department of Gynecology, Chiba University School of Medicine, Chiba, Japan.
J Gynecol Oncol. 2014 Jan;25(1):64-9. doi: 10.3802/jgo.2014.25.1.64. Epub 2014 Jan 8.
Compression of the left common iliac vein between the right common iliac artery and the vertebrae is known to be associated with the occurrence of left iliofemoral deep vein thrombosis (DVT). In this study, we described the variability in vascular anatomy of the common iliac veins and evaluated the relationship between the degree of iliac vein compression and the presence of DVT using the data from surgeries for gynecologic cancer.
The anatomical variations and the degrees of iliac vein compression were determined in 119 patients who underwent systematic para-aortic and pelvic lymphadenectomy during surgery for primary gynecologic cancer. Their medical records were reviewed with respect to patient-, disease-, and surgery-related data.
THE DEGREES OF COMMON ILIAC VEIN COMPRESSION WERE CLASSIFIED INTO THREE GRADES: grade A (n=28, 23.5%), with a calculated percentage of 0%-25% compression; grade B (n=47, 39.5%), with a calculated percentage of 26%-50% compression; and grade C (n=44, 37%), with a calculated percentage of more than 50% compression. Seven patients (5.9%) had common iliac veins with anomalous anatomies; three were divided into small caliber vessels, two with a flattened structure, and two had double inferior vena cavae. The presence of DVT was associated with the elevated D-dimer levels but not with the degree of iliac vein compression in this series.
Although severe compression of the common iliac veins was frequently observed, the degree of compression might not be associated with DVT in surgical patients with gynecologic cancer. Anomalous anatomies of common iliac veins should be considered during systematic para-aortic and pelvic lymphadenectomy in the gynecologic cancer patients.
左髂总静脉在右髂总动脉和椎体之间受压，与左髂股深静脉血栓形成（DVT）的发生有关。本研究描述了髂总静脉血管解剖结构的变异性，并利用妇科癌症手术的数据评估了髂静脉受压程度与 DVT 之间的关系。
对 119 例行原发性妇科癌症手术系统腹主动脉旁和盆腔淋巴结切除术的患者进行了髂总静脉解剖结构和髂静脉受压程度的评估。回顾了与患者、疾病和手术相关的数据的病历。
髂总静脉受压程度分为三级：A 级（n=28，23.5%），受压百分比计算为 0%-25%；B 级（n=47，39.5%），受压百分比计算为 26%-50%；C 级（n=44，37%），受压百分比计算为超过 50%。7 例（5.9%）患者髂总静脉解剖异常；3 例分为小口径血管，2 例呈扁平结构，2 例为双下腔静脉。本研究中，DVT 的存在与升高的 D-二聚体水平相关，但与髂静脉受压程度无关。
尽管常观察到髂总静脉严重受压，但在妇科癌症手术患者中，受压程度与 DVT 无关。在妇科癌症患者进行系统腹主动脉旁和盆腔淋巴结切除术时，应考虑髂总静脉的异常解剖结构。
