Ozsoy Mustafa, Ozsoy Zehra, Sahin Suleyman, Arikan Yüksel
Department of General Surgery, Parkhayat Hospital, Afyon, Turkey.
Department of Internal Medicine, State Hospital, Afyon, Turkey.
Niger J Surg. 2018 Jan-Jun;24(1):60-62. doi: 10.4103/njs.NJS_36_17.
The presacral venous system is located under the pelvic fascia covering the anterior of the sacrum and consists of two lateral sacral veins, middle sacral vein, and the veins that communicate them. The presacral venous system can be easily damaged and causes serious bleeding which is difficult to control and may cause intraoperative mortality. Its incidence varies between 3% and 9.4%. Although several methods have been tried to control presacral bleeding, the definitive method of treatment has not yet been identified. We present here our alternative technique in control of massive presacral massive bleeding developed from the presacral plexus secondary to the traction of the specimen during the dissection. The bleeding could not be controlled despite the use of all technical possibilities such as packing, ligation, and hemostatic agents. Bleeding control was provided by GORE-TEX graft. We conclude that fıxatıon of GORE-TEX aortic patch should be kept in mind for uncontrolled massive presacral bleeding.
骶前静脉系统位于覆盖骶骨前部的盆筋膜下方，由两条骶外侧静脉、骶中静脉以及连接它们的静脉组成。骶前静脉系统很容易受损，会导致难以控制的严重出血，可能会导致术中死亡。其发生率在3%至9.4%之间。尽管已经尝试了多种方法来控制骶前出血，但尚未确定明确的治疗方法。在此，我们介绍一种替代技术，用于控制在解剖过程中因标本牵引继发于骶前丛而导致的大量骶前出血。尽管使用了诸如填塞、结扎和止血剂等所有技术手段，出血仍无法控制。通过戈尔（GORE-TEX）补片实现了出血控制。我们得出结论，对于无法控制的大量骶前出血，应考虑使用戈尔（GORE-TEX）主动脉补片进行固定。
