Sanna Beatrice, Henry Brandon Michael, Vikse Jens, Skinningsrud Bendik, Pękala Jakub R, Walocha Jerzy A, Cirocchi Roberto, Tomaszewski Krzysztof A
International Evidence-Based Anatomy Working Group, Krakow, Poland; Faculty of Medicine & Surgery, University of Cagliari, Sardinia, Italy.
International Evidence-Based Anatomy Working Group, Krakow, Poland; Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland.
Injury. 2018 Feb;49(2):302-308. doi: 10.1016/j.injury.2017.12.007. Epub 2017 Dec 9.
Corona mortis is a highly variable vascular connection between the obturator and external iliac or inferior epigastric arteries or veins located behind the superior pubic ramus in the retropubic space (space of Retzius). Due to the significant variation in this collateral circulation, detailed anatomical knowledge of the corona mortis is vital to enhance the prevention of possible iatrogenic errors in hernia repair and other pubic surgical procedures. The aim of our meta-analysis was to provide comprehensive data on the prevalence, anatomical characteristics, and ethnic variations of the corona mortis vessel.
An extensive search was conducted through the major electronic databases to identify eligible articles. Data extracted included investigative method, prevalence of the corona mortis vessels among hemi-pelvises (overall, arterial only, venous only, and combined), distance from the corona mortis to pubic symphysis, and assessment of gender, side, laterality, and ethnicity subgroups.
A total of 21 studies (n=2184 hemi-pelvises) were included in the meta-analysis. The overall prevalence of the corona mortis in hemi-pelvises is high (49.3%). A venous corona mortis is more prevalent than an arterial corona mortis (41.7% vs. 17.0%). The corona mortis is more common in Asia (59.3%) than in Europe (42.8%) and North America (44.3%).
As a corona mortis is present in an about half of all hemi-pelvises, it is important to consider the possibilities of its presence when undertaking surgical procedures and plan accordingly to avoid injuries. All surgeons operating in the retropubic region should have a thorough understanding of the anatomical characteristics and surgical implications of a corona mortis.
死亡冠是闭孔动脉与髂外动脉或腹壁下动脉或静脉之间高度可变的血管连接，位于耻骨后间隙（雷济厄斯间隙）耻骨上支后方。由于这种侧支循环存在显著变异，详细了解死亡冠的解剖结构对于提高疝修补术和其他耻骨手术中预防可能的医源性失误至关重要。我们进行荟萃分析的目的是提供关于死亡冠血管的患病率、解剖特征和种族差异的全面数据。
通过主要电子数据库进行广泛检索，以识别符合条件的文章。提取的数据包括研究方法、半骨盆中死亡冠血管的患病率（总体、仅动脉、仅静脉和两者皆有）、死亡冠到耻骨联合的距离，以及对性别、侧别、左右侧和种族亚组的评估。
荟萃分析共纳入21项研究（n = 2184个半骨盆）。半骨盆中死亡冠的总体患病率较高（49.3%）。静脉性死亡冠比动脉性死亡冠更常见（41.7%对17.0%）。死亡冠在亚洲（59.3%）比在欧洲（42.8%）和北美（44.3%）更常见。
由于约一半的半骨盆中存在死亡冠，在进行手术时考虑其存在的可能性并相应地制定计划以避免损伤非常重要。所有在耻骨后区域进行手术操作的外科医生都应全面了解死亡冠的解剖特征及其手术意义。
