Filippakis George M, Leandros Manolis, Albanopoulos Kostas, Genetzakis Michael, Lagoudianakis Emmanuel, Pararas Nikos, Konstandoulakis Manousos M
First Department of Propaedeutic General Surgery, Athens University Medical School, Hippocrateion Hospital, Q. Sophia 114, 11527 Athens, Greece.
Am Surg. 2007 Apr;73(4):410-3.
Bleeding originating from the presacral venous plexus during pelvic operations is difficult to control, constituting a potentially life-threatening complication. Although suture ligatures, packing, and placement of tacks are established hemostatic techniques, they are often proved to be ineffective. We report a simple novel technique using spray diathermy for managing this severe complication. We have applied our method in four patients, two undergoing low anterior resection, and the others undergoing abdominoperineal resection for rectal cancer, that manifested severe presacral bleeding during rectal mobilization. Electrocautery at spray setting was applied slightly above the target bleeders at the presacral fascia, delivering a high-frequency electrical current in combination with drainage suction. In all cases, the method resulted in successful hemostasis. Applying spray electrocautery is a simple and effective method for controlling presacral bleeding. The advantages of using such a method instead of conventional hemostatic techniques include the option of varying the degree of haemostatic effect by altering the frequency and the volume of electric current.
盆腔手术中来自骶前静脉丛的出血难以控制，是一种潜在的危及生命的并发症。尽管缝合结扎、填塞和钉合是既定的止血技术，但它们往往被证明是无效的。我们报告一种使用喷雾透热法处理这种严重并发症的简单新技术。我们已将我们的方法应用于4例患者，其中2例接受低位前切除术，另2例接受直肠癌腹会阴联合切除术，这些患者在直肠游离过程中出现严重的骶前出血。在骶前筋膜上，将喷雾模式的电灼器应用于目标出血点上方稍高处，结合引流吸引输送高频电流。在所有病例中，该方法均成功止血。应用喷雾电灼是控制骶前出血的一种简单有效的方法。使用这种方法而非传统止血技术的优点包括可通过改变电流频率和电量来调节止血效果的程度。
