Document Detail

Presacral haemorrhage during rectal cancer resection: Morphological and hydrodynamic considerations.
MedLine Citation:
PMID:  22405887     Owner:  NLM     Status:  Publisher    
INTRODUCTION: Our aim is to identify the location and size of the anterior foramina of sacral vertebral bodies and analyse the haemodynamic variables that could influence the haemorrhagic severity of the injury of the presacral venous plexus. MATERIALS AND METHODS: Using computed axial tomography the morphological data of 70 sacral bones in 67 patients with rectal cancer were recorded, as well as measuring the height between the vena cava and S5. After transfemoral catheterisation the inferior vena cava pressure was recorded in 10 patients with rectal cancer. Hydrodynamic principles, according to Bernoulli's Law, were applied to calculate sacral venous plexus pressure, and the flow rate according to the calibre of a hypothetical venous injury. RESULTS: The maximum diameter ranged from 0.5mm to 4mm in 22% of the cases. All foramina of 2 or more millimetres were located in the S4-S5 region. Sacral plexus venous pressure in lithotomy was almost double the inferior vena cava pressure in normal position. Blood flow ranged from 498 to 1,994ml/min for injuries of sizes between 2 and 4mm, respectively. CONCLUSIONS: Larger calibre foramina are found in vertebral bodies of S4-S5. Venous injury at these levels can reach a flow rate of 2 l/min.
José Enrique Casal Nuñez; María Teresa García Martinez; Alejandro Ruano Poblador; Juan Antonio Sánchez Conde; José Luis Pampín Medela; Enrique Moncada Iribarren; Alberto De Sanildefonso Pereira
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-3-9
Journal Detail:
Title:  Cirugia espanola     Volume:  -     ISSN:  1578-147X     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-3-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1254104     Medline TA:  Cir Esp     Country:  -    
Other Details:
Languages:  ENG; SPA     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 AEC. Published by Elsevier Espana. All rights reserved.
Servicio de Cirugía General y Digestiva, Sección de Coloproctología, Hospital Meixoeiro, Vigo, Pontevedra, España.
Vernacular Title:
Hemorragia presacra durante la resección rectal por cáncer. Consideraciones morfológicas e hidrodinámicas.
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