Laparoscopic repair of external iliac-artery transection during laparoscopic radical prostatectomy.

摘要

BACKGROUND AND PURPOSE: Vascular injuries are the most common complication of pelvic lymph-node dissection. We report a case of total division of the external iliac artery and its immediate laparoscopic repair. METHODS: A 70-year-old man with a prostatic adenocarcinoma (Gleason Score 6) and serum prostate specific antigen concentration of 20 ng/mL had inadvertent external iliac-artery transection during pelvic lymphnode dissection secondary to the abnormal course and anatomy of the artery. Immediate laparoscopic repair was accomplished with a two-needle single-knot technique as is routinely used for the vesicourethral anastomosis. Thereafter, laparoscopic radical prostatectomy was completed. RESULTS: The reconstruction time was 37 minutes. There was no significant blood loss. There were no further intraoperative complications. Postrepair, the femoral pulse was intact, and follow-up duplex color ultrasonography showed good flow. The patient was disharged home on day 7, ambulant and asymptomatic. CONCLUSION: In controlled cicumstances, laparoscopic repair of external iliac-artery transection is feasible and represents a safe alternative to open surgery.