Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/1677-5449.202400031
Jornal Vascular Brasileiro
Artigo de Revisão

Tratamento de lesões penetrantes de veia cava retro-hepática: protocolo de revisão sistemática

Treatment of penetrating injuries of the retrohepatic vena cava: systematic review protocol

Adenauer Marinho de Oliveira Góes Junior; Simone de Campos Vieira Abib; Gustavo Henrique Dumont Kleinsorge; Daniella Adrea Araujo Rossi Vieira; Luis Carlos Uta Nakano

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Resumo

Lesões do segmento retro-hepático da veia cava inferior requerem procedimentos complexos, pois sua exposição sem controle vascular prévio pode acarretar sangramentos incoercíveis e letais. Para este controle, a tríplice exclusão vascular hepática e o implante de shunt átrio-caval foram classicamente descritos e, mais recentemente, estratégias endovasculares foram relatadas. Entretanto, não há consenso na literatura sobre qual dessas estratégias apresenta menor mortalidade. Com a finalidade de definir qual estratégia terapêutica apresenta menor mortalidade e incidência de complicações no tratamento de lesões penetrantes do segmento retro-hepático da cava inferior, será realizada uma revisão sistemática da literatura, a qual foi registrada na plataforma PROSPERO sob o número CRD42023464133. O Cochrane Handbook for Systematic Reviews of Interventions será utilizado para orientar o processo. As buscas serão realizadas nas bases de dados MEDLINE/PubMed, LILACS, Embase, Scopus e Web of Science. O site ClinicalTrials.gov e a Plataforma Internacional de Registro de Ensaios Clínicos (ICTRP) serão consultados para a detecção de ensaios em andamento ou não publicados. Os estudos serão selecionados por uma estratégia de busca previamente estabelecida, o montante de resultados será filtrado utilizando-se o aplicativo Rayyan, e os estudos incluídos serão analisados independentemente por dois autores para construção do senso final. A análise qualitativa dos estudos será feita com a ferramenta RoB 1.0.

Palavras-chave

veia cava inferior; ferimentos e lesões; procedimentos endovasculares; procedimentos de tratamento; procedimentos cirúrgicos operatórios; revisão sistemática

Abstract

Injuries to the retrohepatic segment of the inferior vena cava require complex procedures, as exposure without prior vascular control can lead to uncontrollable and fatal bleeding. To achieve such control, the classic techniques of hepatic vascular exclusion and the implantation of an atriocaval shunt have been described, and more recently, endovascular strategies have been reported. However, there is no consensus in the literature regarding which of these strategies is associated with lower mortality. In order to determine which therapeutic strategy presents the lowest mortality and complication rates in the treatment of penetrating injuries to the retrohepatic segment of the inferior vena cava, a systematic review of the literature will be conducted, registered on the PROSPERO platform under the number CRD42023464133. The Cochrane Handbook for Systematic Reviews of Interventions will guide the process. Searches will be carried out in the MEDLINE/PubMed, LILACS, Embase, Scopus, and Web of Science databases. ClinicalTrials.gov and the International Clinical Trials Registry Platform (ICTRP) will be consulted to detect ongoing or unpublished trials. Studies will be selected based on a predefined search strategy, the number of results will be filtered using the Rayyan app, and the studies included will be independently reviewed by two authors to reach a final consensus. The qualitative analysis of the studies will be conducted using the RoB 1.0 tool.

Keywords

inferior vena cava; wounds and injuries; endovascular procedures; therapeutics; surgical procedures; operative; systematic review

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Submetido em:
15/01/2024

Aceito em:
16/04/2024

Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)"> Sociedade Brasileira de Angiologia e Cirurgia Vascular (SBACV)">
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