POPLÝTEAL ARTER VE VEN YARALANMALARI

1990-1995 yýllarý arasýnda Kartal Eðitim ve Araþtýrma Hastanesi Cerrahi Kliniðinde tedavi edilen 11 popliteal damar yaralanmasý retrospektif olarak incelendi. Yedi olguda arter ve ven yaralanmasý birlikte idi. Dört olguda izole arter yaralanmasý mevcuttu. Sekiz arter ve 1 ven yaralanmasý olgusunda otojen saf en ve ven interpozisyonu, 2 olguda rezeksiyon + uç uca anastomoz, bir olguda primer onarým uygulandý. Arter ve ven yaralanmasý birlikte olan 2 olguda erken sürede arter onarýmý ve ven ligasyonu yapýldý. Kompartman sendromu geliþen bu olgularda ve iki gecikmiþ olguda fasiyotomi uygulandý. Morbidite %36.6, mortalite %9.1, amputasyon oraný %20 bulundu. Popliteal bölgenin vasküler yaralanmalarýnda arter ve ven birlikte yaralanmýþça mümkün olduðunca ven ligasyonundan kaçýnýlmalý, eðer ligasyon uygulanmýþsa fasiotomi ilave edilmelidir.

POPLITEAL ARTERY AND VEIN IN JURIES

Eleven popliteal vascular injuries repaired at surgery Kartal Training and Research Hospital, department in between 1990-1995 were investigated retrospectively. In seven patients vein and artery injuries were together, meanwhile, arterial injury was the single problem in 4 patients. Surgical interventions performed in these patients were; autogen sapheneous vein interpositon in 8 arterial and 1 venous injuries, limited resection (debridment) end to end anastomosis in 2 patients and primary repair in 1 patients. Early arterial repair and vena ligation was performed in two patients who suffered both arterial and venous injury. Compartment syndrome (entrapment) was seen in two other patients due to delay in treatment and fasciotomy was performed in all four patients. In our series morbiditiy was 36.6%, mortality 91% and amputation rate was 20%. In vascular injuries of popliteal region; if both artery and vein are injuried, surgeon must avoid vein ligations as much as possible and if it is ligated than faciotomy must be added to the surgical procedure.