Prednji intra-karlični pristup i corona mortis vaskularne anastomoze: kliničko anatomska studija pokazuje visoku učestalost
Sažetak
Uvod/Cilj. Corona mortis vaskularne anastomoze (CMVA) moraju biti identifikovane i locirane u toku hirurškog zahvata koji predstavlja zlatni standard u lečenju dislociranih preloma acetabuluma. Cilj rada bio je da se odgovori na sledeća pitanja: kolika je klinička učestalost CMVA, kao i kakva je struktura CMVA – arterijska, venska ili kombinovana. Metode. Izvršena je retrospektivna analiza 31 bolesnika (24 žene i sedam muškaraca, prosečne starosti 43,5 godina) koji su operisani zbog frakture acetabuluma u periodu od 2011. do 2015. godine. Prednji intrakarlični (PIK) pristup je bio primenjen kod svih bolesnika. Intraoperativno su bili praćeni i beleženi: struktura CMVA i učestalost, istovremeno sa identifikacijom venske ili arterijske formacije, kao i udaljenost od pubične simfize. Rezultati. CMVA su bile uočene tokom disekcije kod 29 (94%) bolesnika i podvezane. Kod 14 (45%) bolesnika CM, god sedam (23%) bolesnika arterijske i kod njih osam (26%) kombinovane. Prosečna udaljenost CMVA od pubične simfize iznosila je 35,9 mm (opseg 21,6–48,7 mm). Zaključak. Rezultati su pokazali veoma visoku učestalost CMVA kod PIK pristupa, višu od ranije objavljenih u literaturi na engleskom jeziku. Ortopedi bi trebali da ovo imaju u vidu kod PIK pristupa u hirurškom lečenju fraktura acetabuluma.
Reference
Rommens P, Broos P, Vanderschot P. Preparation and technique for surgical treatment of 225 acetabulum fractures. 2 year re-sults of 175 cases. Unfallchirurg 1997; 100(5): 338–48. (German)
Tannast M, Najibi S, Matta JM. Two to twenty-year survivor-ship of the hip in 810 patients with operatively treated ace-tabular fractures. J Bone Joint Surg Am 2012; 94(17): 1559–67.
Cole JD, Bolhofner BR. Acetabular fracture fixation via a modi-fied Stoppa limited intrapelvic approach. Description of oper-ative technique and preliminary treatment results. Clin Or-thop Relat Res 1994; (305): 112–23.
Hammad AS, El-Khadrawe TA. Accuracy of reduction and early clinical outcome in acetabular fractures treated by the stand-ard ilio-inguinal versus the Stoppa/iliac approaches. Injury 2015; 46(2): 320–6.
Isaacson MJ, Taylor BC, French BG, Poka A. Treatment of ace-tabulum fractures through the modified Stoppa approach: strategies and outcomes. Clin Orthop Relat Res 2014; 472(11): 3345–52.
Hirvensalo E, Lindahl J, Kiljunen V. Modified and new ap-proaches for pelvic and acetabular surgery. Injury 2007; 38(4): 431–41.
Archdeacon MT, Kazemi N, Guy P, Sagi HC. The modified Stoppa approach for acetabular fracture. J Am Acad Orthop Surg 2011; 19(3): 170–5.
Bastian JD, Tannast M, Siebenrock KA, Keel MJ. Mid-term re-sults in relation to age and analysis of predictive factors after fixation of acetabular fractures using the modified Stoppa ap-proach. Injury 2013; 44(12): 1793–8.
Elmadağ M, Güzel Y, Acar MA, Uzer G, Arazi M. The Stoppa approach versus the ilioinguinal approach for anterior ace-tabular fractures: a case control study assessing blood loss complications and function outcomes. Orthop Traumatol Surg Res 2014; 100(6): 675–80.
Kacra BK, Arazi M, Çiçekcibaşı AE, Büyükmumcu M, Demirci S. Modified medial Stoppa approach for acetabular fractures: an anatomic study. J Trauma 2011; 71(5): 1340–4.
Sagi HC, Afsari A, Dziadosz D. The anterior intra-pelvic (modified rives-stoppa) approach for fixation of acetabular fractures. J Orthop Trauma 2010; 24(5): 263–70.
Berberoğlu M, Uz A, Özmen MM, Bozkurt MC, Erkuran C, Taner S, et al. Corona mortis. Surg Endosc 2001; 15(1): 72–5.
Darmanis S, Lewis A, Mansoor A, Bircher M. Corona mortis: an anatomical study with clinical implications in approaches to the pelvis and acetabulum. Clin Anat 2007; 20(4): 433–9.
Gobrecht U, Kuhn A, Fellman B. Injury of the corona mortis during vaginal tape insertion (TVT-Secur™ using the U-Approach). Int Urogynecol J 2011; 22(4): 443–5.
Ramser M, Messmer AS, Zbinden I, Von Holzen U, Nebiker CA. Incarcerated obturator hernia–laparoscopic repair with in-traoperative view of the corona mortis. J Surg Case Rep 2014; 2014(8): pii: rju081.
Rusu MC, Cergan R, Motoc AG, Folescu R, Pop E. Anatomical considerations on the corona mortis. Surg Radiol Anat 2010; 32(1): 17–24.
Sarikcioglu L, Sindel M, Akyildiz F, Gur S. Anastomotic vessels in the retropubic region: corona mortis. Folia Morphol (Warsz) 2003; 62(3): 179–82.
Judet R, Judet J, Lanzetta A, Letournel E. Fractures of the ace-tabulum. Classification and guiding rules for open reduction. Arch Ortop 1968; 81(3): 119–58. (Italian)
Hirvensalo E, Lindahl J, Böstman O. A new approach to the in-ternal fixation of unstable pelvic fractures. Clin Orthop Relat Res 1993; (297): 28–32.
Tornetta P 3rd, Hochwald N, Levine R. Corona mortis. Incidence and location. Clin Orthop Relat Res 1996; (329): 97–101.
Lau H, Lee F. A prospective endoscopic study of retropubic vascular anatomy in 121 patients undergoing endoscopic ex-traperitoneal inguinal hernioplasty. Surg Endosc 2003; 17(9): 1376–9.
Okcu G, Erkan S, Yercan HS, Ozic U. The incidence and loca-tion of corona mortis: a study on 75 cadavers. Acta Orthop Scand 2004; 75(1): 53–5.
Stavropoulou-Deli A, Anagnostopoulou S. Corona mortis: anatomi-cal data and clinical considerations. Aust N Z J Obstet Gynae-col 2013; 53(3): 283–6.
Karakurt L, Karaca I, Yılmaz E, Burma O, Serin E. Corona mor-tis: incidence and location. Arch Orthop Trauma Surg 2002; 122(3): 163–4.
Sakthivelavan S, Aristotle S, Sendiladibban SD, Jebakkani CF. Variability of the obturator artery and its surgical implications in a South Indian population. Eur J Anat 2013; 17(3): 159–65.
Pai MM, Krishnamurthy A, Prabhu LV, Pai MV, Kumar SA, Hadimani GA. Variability in the origin of the obturator artery. Clinics (Sao Paulo) 2009; 64(9): 897–901.
Teague DC, Graney DO, Routt ML Jr. Retropubic vascular haz-ards of the ilioinguinal exposure: a cadaveric and clinical study. J Orthop Trauma 1996; 10(3): 156–9.
Hong HX, Pan ZJ, Chen X, Huang ZJ. An anatomical study of corona mortis and its clinical significance. Chin J Traumatol 2004; 7(3): 165–9.
Pungpapong S, Thum-umnauysuk S. Incidence of corona mortis; preperitoneal anatomy for laparoscopic hernia repair. J Med Assoc Thai 2005; 88(Suppl 4): S51–3.