Schuetter F W, Loose D A
Int Surg. 1983 Jan-Mar;68(1):41-6.
The problems associated with postoperative iatrogenic vascular lesions in 13 patients are discussed. In general surgery, there is no particular procedure which entails an extremely high risk of iatrogenic vascular lesions. Depending on the kind of lesion, hemorrhage and ischemia are the most frequent symptoms. The IVL was recognized during the initial operation in only two cases. Interposition of autologous saphenous vein is the safest therapeutic procedure. End-to-end anastomosis and patches to enlarge the anastomosis can also be used. In venous lesions, we recommend the creation of a temporary AV-fistula. In one case a thigh amputation was necessary because of progressive venous gangrene; operation was performed five days after the lesion. Postoperatively, two cubital interpositions were occluded; but the patients did not suffer from circulatory problems. One female patient died following resection of a carotid aneurysm originating from a glomectomy. Good postoperative results were reported for the other patients.
讨论了13例患者术后医源性血管病变相关的问题。在普通外科中，没有哪种特定手术会带来极高的医源性血管病变风险。根据病变类型，出血和缺血是最常见的症状。仅两例在初次手术时就识别出了医源性血管病变。自体大隐静脉移植是最安全的治疗方法。也可采用端端吻合和补片扩大吻合口。对于静脉病变，我们建议建立临时动静脉瘘。有1例因进行性静脉坏疽而需要大腿截肢；在病变发生五天后进行了手术。术后，两根肘窝移植血管闭塞，但患者未出现循环问题。1例女性患者在切除源于球切除术的颈动脉动脉瘤后死亡。其他患者术后结果良好。
