Department of Vascular Surgery, Al-Hussain University Hospital, Faculty of Medicine for Males, Al-Azhar University, Cairo, Egypt; Divisions of Vascular Surgery, Pediatric Surgery, Emergency Medicine, General Surgery, Department of Surgery, College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia.
Divisions of Vascular Surgery, Pediatric Surgery, Emergency Medicine, General Surgery, Department of Surgery, College of Medicine, King Faisal University, Al-Ahsa, Saudi Arabia; Divisions of Pediatric Surgery, Emergency Surgery, Department of General and Emergency Surgery, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.
Asian J Surg. 2019 Jul;42(7):761-767. doi: 10.1016/j.asjsur.2018.09.012. Epub 2018 Nov 3.
To evaluates the management and outcome of non-iatrogenic pediatric and adolescence extremity arterial injuries in a resource-challenged setting.
A retrospective study of the surgical management for non-iatrogenic extremity arterial trauma in pediatric and adolescence during the period from January 2008 to December 2015. This study was performed in two different countries at tertiary referral university and teaching hospitals having a specialized emergency and trauma centers. A thorough study of each patient record was collected from these centers including, the original demographic data and their clinical presentations. Operative data of each patient was also reported.
During the 8-year period of the study, 149 pediatric and adolescent extremity arterial trauma patients were treated. They were 93.3% male, and 6.7% female, respectively. The age ranged from 2 to 18 years with a mean of 10.25 ± 4.05 years. Lower extremity arterial trauma was recorded in 51%, while 49% were having upper extremity injuries. Primary repair with end-to-end vascular anastomosis was performed in 51.7%, while an interposition reversed saphenous vein graft was performed in 48.3%. The operative procedures were performed by an experienced vascular surgeon and well-trained pediatric surgeons and general surgeons. Pseudoaneurysms was recorded in 9% of cases. Fasciotomy was performed in 15% of cases.
Treatment of pediatric and adolescent extremity arterial injuries with primary end-to-end vascular anastomoses or with the use of an interposition reversed saphenous vein graft is a reliable, feasible, and more cost-effectiveness technique with good results. Moreover, it should be adopted for all vascular trauma patients, whenever possible.
评估资源有限环境下非医源性小儿和青少年肢体动脉损伤的处理和结局。
对 2008 年 1 月至 2015 年 12 月期间，在两所不同国家的三级转诊大学和教学医院的专门急诊和创伤中心，对小儿和青少年非医源性肢体动脉外伤的手术处理进行回顾性研究。从这些中心收集了每位患者的详细病历记录，包括原始人口统计学数据和临床表现。还报告了每位患者的手术数据。
在研究的 8 年期间，共治疗了 149 例小儿和青少年肢体动脉创伤患者。他们分别为 93.3%男性和 6.7%女性，年龄 2 至 18 岁，平均 10.25 ± 4.05 岁。下肢动脉创伤占 51%，上肢损伤占 49%。51%采用端端血管吻合术进行一期修复，48.3%采用大隐静脉逆行转位移植术。手术程序由经验丰富的血管外科医生以及训练有素的小儿外科医生和普通外科医生共同完成。9%的病例记录有假性动脉瘤，15%的病例进行了筋膜切开术。
采用端端血管吻合术或大隐静脉逆行转位移植术治疗小儿和青少年肢体动脉损伤是一种可靠、可行且更具成本效益的技术，效果良好。此外，只要可能，应将其应用于所有血管创伤患者。
