WSES position paper on vascular emergency surgery.
Trauma, both blunt and penetrating, is extremely common worldwide, as trauma to major vessels. The management of these patients requires specialized surgical skills and techniques of the trauma surgeon. Furthermore few other surgical emergencies require immediate diagnosis and treatment like a ruptured abdominal aortic aneurysm (rAAA). Mortality of patients with a rAAA reaches 85 %, with more than half dying before reaching the hospital. These are acute events demanding immediate intervention to save life and limb and precluding any attempt at transfer or referral. It is the purpose of this position paper to discuss neck, chest, extremities and abdominal trauma, bringing to light recent evidence based data as well as expert opinions; besides, in this paper we present a review of the recent literature on rAAA and we discuss the rationale for transfer to referral center, the role of preoperative imaging and the pros and cons of Endoluminal repair of rAAA (REVAR) versus Open Repair (OR).
Division of Trauma Surgery, Department of Surgery, School of Medical Sciences, University of Campinas (Unicamp), Campinas, SP Brazil.
Bruno Monteiro T
BM
Pereira
Trauma Team, Ospedale Niguarda Milano, Milan, Italy.
Osvaldo
O
Chiara
Department of Cardiothoracic Surgery, John Hunter Hospital, Newcastle, NSW Australia.
Fabio
F
Ramponi
Department of Traumatology, John Hunter Hospital, Newcastle, NSW Australia.
Dieter G
DG
Weber
Trauma Team, Ospedale Niguarda Milano, Milan, Italy.
Stefania
S
Cimbanassi
Department of Emergency and Trauma Surgery of the University Hospital of Parma, Parma, Italy.
Belinda
B
De Simone
Department of Cardiothoracic Surgery, John Hunter Hospital, Newcastle, NSW Australia.
Korana
K
Musicki
Division of Trauma Surgery, Department of Surgery, School of Medical Sciences, University of Campinas (Unicamp), Campinas, SP Brazil.
Guilherme Vieira
GV
Meirelles
Department of Emergency and Trauma Surgery of the University Hospital of Parma, Parma, Italy.
Fausto
F
Catena
Department of general and emergency surgery, Papa Giovanni XIII Hospital, Bergamo, Italy.
Luca
L
Ansaloni
Department of general and emergency surgery, Papa Giovanni XIII Hospital, Bergamo, Italy.
Federico
F
Coccolini
Department of surgery, Macerata Hospital, Macerata, Italy.
Massimo
M
Sartelli
Department of surgery, Maggiore Hospital of Bologna, Bologna, Italy.
Salomone
S
Di Saverio
Department of Traumatology, John Hunter Hospital, Newcastle, NSW Australia.
Cino
C
Bendinelli
Division of Trauma Surgery, Department of Surgery, School of Medical Sciences, University of Campinas (Unicamp), Campinas, SP Brazil.
Gustavo Pereira
GP
Fraga
Ruptured abdominal aorta aneurism; Trauma; Vascular Trauma: Neck, Chest and Extremities; Vascular control; Vascular injuries