Control of presacral venous bleeding during rectal surgery

Area of Science:

• Surgical Oncology
• Gastroenterology
• Vascular Surgery

Background:

• Presacral venous hemorrhage is a rare but serious complication of rectal surgery.
• Conventional hemostatic methods are often insufficient for controlling this type of bleeding.
• Alternative hemostasis techniques are being explored.

Purpose of the Study:

• To evaluate the efficacy of a combined hemostatic matrix and absorbable hemostat for managing severe presacral venous hemorrhage.
• To present clinical experience with this combined hemostatic approach.

Main Methods:

• A retrospective review of 83 patients undergoing rectal surgery between September 2007 and March 2009.
• Three patients experienced severe presacral hemorrhage.
• Hemostasis was achieved using a combination of FloSeal (hemostatic matrix) and Surgicel Fibrillar (absorbable hemostat).

Main Results:

• The combined hemostatic agents successfully controlled severe presacral hemorrhage in all three affected patients.
• Only one patient required an intraoperative blood transfusion.
• Postoperative blood loss was minimal, with drains removed on postoperative day 4.

Conclusions:

• The combination of a hemostatic matrix and an absorbable hemostat provides an effective and straightforward method for arresting presacral bleeding.
• This approach is particularly valuable when conventional hemostatic measures prove inadequate.