Andriole G L, Sugarbaker P H
Dis Colon Rectum. 1985 Mar;28(3):183-4. doi: 10.1007/BF02554240.
Abdominoperineal resection with pelvic sidewall dissection is not uncommonly performed for treatment of bulky primary or locally recurrent rectal neoplasms. Usually, the internal iliac arteries and veins are ligated bilaterally early in the course of the procedure to reduce intraoperative blood loss and to facilitate subsequent dissection of the pelvic sidewalls. No complications related to bilateral internal iliac artery ligation in this setting have been described previously. In this report, profound vesical and perineal necrosis after bilateral internal iliac artery ligation occurred in a female patient operated on for recurrent rectal cancer. If the internal iliac artery is ligated below the take-off of the gluteal vessels, perineal necrosis can be prevented.
腹会阴联合切除术加盆腔侧壁清扫术常用于治疗体积较大的原发性或局部复发性直肠肿瘤。通常，在手术过程早期双侧结扎髂内动静脉，以减少术中失血并便于随后的盆腔侧壁清扫。此前尚未有关于在此种情况下双侧结扎髂内动脉相关并发症的报道。在本报告中，一名接受复发性直肠癌手术的女性患者在双侧结扎髂内动脉后发生了严重的膀胱和会阴坏死。如果在臀血管起始部以下结扎髂内动脉，则可预防会阴坏死。
