Outcome of iatrogenic injuries to the abdominal and pelvic veins.
OBJECTIVE
To analyze the management and outcome of iatrogenic injuries to the abdominal and pelvic veins.


METHODS
We reviewed a series of patients who sustained iatrogenic vein injuries between 1989 and 2004.


RESULTS
Thirty patients (21 men and 9 women ranging in age from 38 to 82 years; mean age, 53.6 years) sustained major vein injuries during general (46%), gynecological (20%), orthopedic (13%), colorectal (10%), or urologic (10%) operations. The following veins were injured: inferior vena cava (n=10), portal vein (n=4), iliac vein (n=15), and renal vein (n=1). The following types of repair were carried out: venorrhaphy (56%), end-to-end anastomosis (10%), and an interposition graft (33%). Seven patients (23%) died of injury-related causes and 18 (60%) suffered major injury-related complications, including bleeding requiring repeat exploration (n=7), disseminated vascular coagulopathy (DIC; n=5), venous thrombosis (n=4), and lower limb arterial ischemia (n=2). There were two cases of late venous thrombosis.


CONCLUSIONS
Iatrogenic vein injuries can occur during radical surgery for cancer and are associated with high morbidity and mortality as a result of massive bleeding. Rapid vascular control and venous repair improve early and late outcome.
Mandolfino
Tommaso
T
Vascular Surgery Section, Department of Surgery, University Hospital of Messina, Messina, Italy.
Canciglia
Aldo
A
Taranto
Filippo
F
D'Alfonso
Mario
M
Tonante
Agata
A
Mamo
Marcello
M
Sturniolo
Giovanni
G
D000005:Abdomen / Q000098:blood supply; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D007431:Intraoperative Complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000098:blood supply; D012189:Retrospective Studies; D016896:Treatment Outcome; D014680:Veins / Q000293:injuries* / Q000601:surgery*