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Systematic Review of the Management of Retro-Hepatic Inferior Vena Cava Injuries

机译：系统审查减速火箭 - 肝脏下腔静脉伤害

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Background: Retro-hepatic inferior vena cava (RHIVC) injuries resulting from blunt or penetrating abdominal trauma are rare but devastating events that remain a considerable challenge to even the most experienced doctors, which continue to carry a considerable mortality. Aim: To establish a better understanding of the management of RHIVC injuries and to identify any adjuncts or operative methods that were associated with an increased survival. Methods: A systematic review of the MEDLINE database was conducted using Medical Search Headings and exploded keywords and phrases. Studies were screened and subjected to inclusion/exclusion criteria. Data were extracted in a methodical manner collecting population demographics, morbidity, mortality and operative intervention, where provided. Operative strategies were compared and discussed. Results: An initial search identified 483 articles. Following duplicate removal and abstract screening, 85 full-text articles were assessed with 25 meeting the desired criteria and were, therefore, included in the systematic review. Key operative strategies and complications were identified and discussed. Conclusion: The wide variety of operative interventions in the management of RHIVC liver injuries described attest to the increased efforts to improve outcomes. The overall improvement in mortality can be noted since the earlier descriptions reported mortality approaching 100% compared to the 52% reported in this review. An algorithm has been proposed based on these findings and our experiences for the management of RHIVC injuries.
机译：背景：钝性或渗透腹腔创伤引起的重新肝脏下腔静脉（Rhivc）损伤是罕见的但毁灭性的事件，即使是最有经验的医生仍然是一个相当大的挑战，这继续携带相当大的死亡率。目的：建立更好地了解Rhivc伤害的管理，并确定与增加的生存率相关的任何辅助或手术方法。方法：使用医疗搜索标题和分解关键字和短语进行MEDLINE数据库的系统审查。筛选研究并进行包含/排除标准。通过提供提供的人口统计学，发病率，死亡率和手术干预的方法提取数据。比较和讨论了手术策略。结果：初始搜索已确定483篇文章。在重复删除和抽象筛选之后，通过25次满足所需标准进行评估85个全文文章，因此包括在系统审查中。确定和讨论了主要的手术策略和并发症。结论：Rhivc肝脏伤害管理中的各种手术干预措施证明了提高改善结果的努力。可以指出死亡率的总体改善，因为与本综述报告的52％的52％相比，死亡率达到了100％的死亡率。基于这些调查结果提出了一种算法，以及我们对Rhivc伤害管理的经验。

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