Fruhwirth J, Koch G, Mischinger H J, Werkgartner G, Tesch N P
Department of Vascular Surgery, Karl Franzens University Graz, Austria.
Surg Laparosc Endosc. 1997 Jun;7(3):251-4.
Injuries to major vessels in the course of laparoscopic surgery are rare but serious, life-threatening complications. We report nine iatrogenic vascular injuries during minimally invasive surgery that occurred between January 1991 and December 1995 in surgical and obstetric-gynecologic services in the Austrian province of Styria. The total vascular complication rate is 0.08%. As these data show, the distal abdominal aorta and vena cava, as well as the large pelvic vessels, are especially susceptible to injury when the Veress needle and trocars are inserted into the abdomen. Surgical reconstruction of these eight arterial lesions required a polytetrafluorethylene (PTFE) patch in one case, and the resection of the damaged section of the artery and reanastomosis in two others. The remaining lesions, as well as an isolated vein injury, were corrected with direct suturing of the vessel. Pelvic circulation was completely restored in all patients, and permanent damage was avoided.
腹腔镜手术过程中主要血管损伤虽罕见，但却是严重的、危及生命的并发症。我们报告了1991年1月至1995年12月期间在奥地利施蒂里亚州外科和妇产科服务中发生的9例微创手术中的医源性血管损伤。总的血管并发症发生率为0.08%。如这些数据所示，当韦雷斯针和套管针插入腹部时，腹主动脉远端、腔静脉以及大的盆腔血管特别容易受到损伤。这8例动脉损伤的手术重建中，1例需要聚四氟乙烯（PTFE）补片，另外2例需要切除受损动脉段并重新吻合。其余损伤以及1例孤立的静脉损伤通过直接缝合血管得到纠正。所有患者的盆腔循环均完全恢复，避免了永久性损伤。
