Treatment of penetrating injuries to the retrohepatic inferior vena cava: a systematic review

肝后下腔静脉穿透伤的治疗:系统性综述

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Abstract

BACKGROUND: Injuries to the retrohepatic vena cava are associated with high mortality rates and vascular control must be obtained prior to exposure. Various treatment techniques have been described, including triple hepatic vascular exclusion, atriocaval shunt, and endovascular and hybrid strategies. OBJECTIVES: To determine which of these is associated with the lowest mortality rate. METHODS: A systematic literature review was conducted, guided by the Cochrane Handbook and PRISMA guidelines. The PUBMED, LILACS, Embase, Web of science, and Scopus databases were searched and Ryyan software was employed to manage the studies identified. RESULTS: Sixteen studies were selected, reporting 96 cases, in 49 of which the patients were treated with triple hepatic exclusion, in 38 with an atriocaval shunt, and in 9 with endovascular or hybrid techniques, with the third of these groups being statistically less frequent (p < 0.0001). The mortality rate was 53.8%, with no statistically significant differences between any of the techniques studied (p = 0.9085). CONCLUSIONS: Injuries to the retrohepatic vena cava had similar mortality rates regardless of the technique employed for treatment.

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