Papalambros E, Sigala F, Felekouras E, Prassas E, Giannopoulos A, Aessopos A, Bastounis E, Hepp W
First Department of Surgery, University of Athens Medical School, Atens, Greece.
Zentralbl Chir. 2005 Jun;130(3):267-9. doi: 10.1055/s-2005-836528.
Although massive presacral bleeding during rectal mobilization is uncommon, it can rapidly destabilize a patient. So, effective hemostasis is critical in severe presacral hemorrhage due to the fatal course of this complication. Among the reported methods are packing, thumbtacks, inflatable devices, muscle tamponade, muscle fragment welding and application of endoscopic staplers. Local hemostatic agents in conjunction with other methods such as diathermy, cyanoacrylate tissue adhesives and application of bone wax are among other alternatives which may help to treat this serious complication. The aim of this study is to describe the anatomic and physiologic basis of our mode of treatment, which is new in the literature approach, treating two patients with presacral bleeding during low anterior resection for rectal cancer. The technique is the early clamping of the infrarenal aorta and suture ligation of the bleeding points from the presacral plexus.
尽管直肠游离过程中出现大量骶前出血并不常见，但它会迅速使患者病情不稳定。因此，由于这种并发症的致命病程，有效的止血在严重骶前出血中至关重要。报告的方法包括填塞、图钉、充气装置、肌肉填塞、肌肉碎片焊接以及应用内镜吻合器。局部止血剂与其他方法如透热疗法、氰基丙烯酸酯组织粘合剂和骨蜡的应用是其他可能有助于治疗这种严重并发症的替代方法。本研究的目的是描述我们治疗方式的解剖学和生理学基础，这是文献中一种新的方法，治疗两名直肠癌低位前切除术中出现骶前出血的患者。该技术是早期钳夹肾下主动脉并缝合结扎来自骶前神经丛的出血点。
