Arteriovenous fistula after robot‐assisted laparoscopic prostatectomy: A rare case report
Arteriovenous fistula after robot‐assisted laparoscopic prostatectomy: A rare case report
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机器人辅助腹腔镜前列腺切除术后动静脉瘘：罕见病例报告
DOI：
10.1002/iju5.12072
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发表时间：
2019
期刊：
影响因子：
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通讯作者：
Inoue Takahiro
中科院分区：
文献类型：
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作者：
Suzuki Ryosuke;Goto Takayuki;Kohno Shigeshi;Kita Yuki;Shimizu Hironori;Kobayashi Takashi;Yamasaki Toshinari;Ogawa Osamu;Inoue Takahiro
根治性直肠癌切除术后发生动静脉瘘是非常罕见的。我们报告了一例罕见的机器人辅助腹腔镜前列腺切除术后并发动静脉瘘的假性动脉瘤病例。病例介绍一名67岁的男性前列腺腺癌患者接受了机器人辅助腹腔镜前列腺切除术。患者出现发热和下腹痛，伴腹膜刺激体征，术后第11天血红蛋白水平下降。通过对比增强计算机断层扫描检测到盆腔出血伴血管外渗漏，他接受了紧急血管造影术。在左髂内动脉的分支证实了动脉瘤样扩张伴早期静脉引流，我们诊断为动静脉瘘。经导管动脉栓塞术，动脉瘤结构随后消失。结论动静脉瘘可能发生的机器人辅助腹腔镜直肠癌切除术的并发症。经导管动脉栓塞似乎是一种有用的微创治疗方法。
IntroductionArteriovenous fistula after radical prostatectomy is very uncommon. We report a rare case of pseudoaneurysm associated with arteriovenous fistula following robot‐assisted laparoscopic prostatectomy.Case presentationA 67‐year‐old man diagnosed with prostatic adenocarcinoma underwent robot‐assisted laparoscopic prostatectomy. He had a fever and lower abdominal pain with sign of peritoneal irritation, and his blood hemoglobin level dropped on postoperative day 11. Hemorrhage in the pelvic space with extravascular leakage was detected by contrast‐enhanced computed tomography, and he underwent emergency angiography. An aneurysmal dilatation with early venous drainage was confirmed in a branch of the left internal iliac artery, and we diagnosed arteriovenous fistula. Transcatheter arterial embolization was performed, and the aneurysmal structure subsequently disappeared.ConclusionArteriovenous fistula may occur as a complication of robot‐assisted laparoscopic prostatectomy. Transcatheter arterial embolization appears to be a useful and minimally invasive treatment.