Wang Q Y, Shi W J, Zhao Y R, Zhou W Q, He Z R
Arch Surg. 1985 Sep;120(9):1013-20. doi: 10.1001/archsurg.1985.01390330025005.
In the past, surgeons thought that severe presacral hemorrhage during proctectomy was caused by damage of the presacral venous plexus. By studying the anatomy and clinical data, we found that injury of the sacral basivertebral vein also caused this serious complication. Presacral hemorrhage is seen as massive bleeding from the distal pelvic surface of sacrum or from one to several large-caliber foramina of sacral basivertebral veins in that area. This type of presacral hemorrhage is more dangerous than that from simple injury of presacral venous plexus and sometimes it is fatal. We describe the anatomic features of the vertebral venous system and its close relationship with severe presacral hemorrhage. We also propose some new concepts about cause, hemostatic measures, and principles of prevention.
过去，外科医生认为直肠切除术中严重的骶前出血是由骶前静脉丛损伤所致。通过对解剖结构和临床资料的研究，我们发现骶椎基底静脉损伤也会导致这种严重并发症。骶前出血表现为骶骨远端盆腔面或该区域骶椎基底静脉的一至数个大口径孔大量出血。这种类型的骶前出血比单纯骶前静脉丛损伤引起的出血更危险，有时甚至会致命。我们描述了椎静脉系统的解剖特征及其与严重骶前出血的密切关系。我们还提出了一些关于病因、止血措施及预防原则的新概念。
