oncotomskСибирский онкологический журналSiberian journal of oncology1814-48612312-3168Tomsk National Research Medical Сепtеr of the Russian Academy of Sciences10.21294/1814-4861-2020-19-6-126-132oncotomsk-1650Research ArticleОБЗОРЫREVIEWSЭВОЛЮЦИЯ МЕТОДОВ ОСТАНОВКИ КРОВОТЕЧЕНИЯ ИЗ ПРЕСАКРАЛЬНОГО ВЕНОЗНОГО СПЛЕТЕНИЯ В ХИРУРГИИ ТАЗА: ОБЗОР ЛИТЕРАТУРЫEVOLUTION OF METHODS OF STOPPING BLEEDING FROM THE PRESACRAL VENOUS PLEXUS IN PELVIC SURGERY: A REVIEW OF THE LITERATUREhttps://orcid.org/0000-0003-0379-0186ПарфирьеваЕ. М.ParfirevaE. M.

врач-онколог

SPIN-код: 8603-6060. Researcher ID (WOS): B-5536-2018

Россия, 634050, г. Томск, пр. Ленина, 115

MD, Oncologist

Researcher ID (WOS): B-5536-2018

115, Lenina Prospect, 634054, Tomsk, Russia

forerunner@yandex.ruhttps://orcid.org/0000-0002-3697-1816ИвченкоА. О.IvchenkoA. O.

доктор медицинских наук, доцент, заведующий кафедрой факультетской хирургии,

SPIN-код: 3979-6802. AuthorID (РИНЦ): 786688. Researcher ID (WOS): S-2704-2016

Россия, 634050, г. Томск, Московский тракт, 2

MD, DSc, Assistant Professor, Head of the Department of Faculty Surgery

Researcher ID (WOS): S-2704-2016

2, Moskovskiy Trakt, 634050, Tomsk, Russia

https://orcid.org/0000-0002-7686-3481ИвченкоО. А.IvchenkoO. A.

доктор медицинских наук, профессор кафедры факультетской хирургии

SPIN-код: 6076-7090. AuthorID (РИНЦ): 785944. Researcher ID (WOS): S-5934-2016

Россия, 634050, г. Томск, Московский тракт, 2

MD, DSc, Professor, Department of Faculty Surgery

Researcher ID (WOS): S-5934-2016

2, Moskovskiy Trakt, 634050, Tomsk, Russia

АвгустиновичА. В.AvgustinovichA. V.

кандидат медицинских наук, старший научный сотрудник отделения абдоминальнойонкологии

SPIN-код: 2952-6119. AuthorID (РИНЦ): 558788

Россия, г. Томск, 634009, пер. Кооперативный, 5

MD, PhD, Senior Researcher, Department of Abdominal Oncology

5, Kooperativny Street, 634009, Tomsk, Russia

ОГАУЗ «Томский областной онкологический диспансер»РоссияTomsk Regional Cancer CenterRussian FederationФГБОУ ВО «Сибирский государственный медицинский университет» Минздрава РоссииРоссияSiberian State Medical UniversityRussian FederationНаучно-исследовательский институт онкологии, Томский национальный исследовательский медицинский центр Российской академии наукРоссияCancer Research Institute, Tomsk National Research Medical Center, Russian Academy of SciencesRussian Federation202030122020196126132Copyright © Парфирьева Е.М., Ивченко А.О., Ивченко О.А., Августинович А.В., 20202020Парфирьева Е.М., Ивченко А.О., Ивченко О.А., Августинович А.В.Parfireva E.M., Ivchenko A.O., Ivchenko O.A., Avgustinovich A.V.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.siboncoj.ru/jour/article/view/1650

Целью исследования является анализ литературы, посвященной проблеме остановки кровотечения из пресакрального венозного сплетения.

Материал и методы

Материал и методы. Поиск источников литературы осуществлялся по базам данных  elibrary, medline, embase с периодом охвата от января 1960 по ноябрь 2018 г. 

Результаты

Результаты. Кровотечение из пресакрального венозного сплетения хоть и не частое, но потенциально летальное осложнение в хирургии таза. Нижняя полая вена, вены пресакрального и внутреннего позвоночного сплетений расширены под общим наркозом  и действуют как крупный венозный «бассейн» в малом тазу из-за отсутствия функциональных клапанов. Гидростатическое давление в этом венозном бассейне может достигать два-три показателя давления нижней полой вены. Таким образом, разрыв даже небольшой пресакральной вены приводит к обильному кровотечению.  Среди множества предложенных способов остановки такого рода кровотечений  наиболее эффективными являются: механические тампонада; прижатие зоны;  электрокоагуляция, наложение кровоостанавливающих швов как в монорежиме, так и в комбинации с биологическим материалом; применение гемостатических материалов.

Заключение

Заключение. Разнообразие используемых способов, публикации новых статей свидетельствуют не только об относительной их эффективности, но и о постоянном поиске более надежного метода. 

The purpose of the study was to analyze various methods of stopping bleeding from the presacral venous plexus.

Material and Methods

Material and Methods. Literature search was carried out using Elibrary, Medline, Embase databases from January 1960 to November 2018.

Results

Results. Bleeding from the presacral venous plexus is a rare but potentially life-threatening complication in pelvic surgery. The inferior vena cava, the veins of the presacral and internal spinal plexuses are dilated under general anesthesia, and act as a large venous “blood pool” in the pelvis because of the lack of functional valves. Hydrostatic pressure in this venous pool can reach two to three times the pressure of the inferior vena cava. Thus, rupture of even a small presacral vein may result in heavy bleeding. Among the many reported methods of stopping this bleeding, the most effective are as follows: mechanical tamponade; technique of pressing the bleeding site; ectrocoagulation; the use of hemostatic materials.

Сonclusion

Сonclusion. The variety of methods used for stopping bleeding from the presacral venous plexus indicate a need of searching for more effective methods.

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The authors declare that there are no conflicts of interest present.