A Review of the Management of Severe Bleeding from the AnteriorSacrum in Rectal Surgery
نویسندگان
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5 Assistant Professor of General Surgery, Tehran University of Medical Sciences, Colorectal Research Center, Imam Khomaini Hospital, Tehran, Iran
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چکیده
Venous bleeding from the anterior surface of the sacrum is a potentially life-threatening complication inrectal surgeries and pelvic dissection. Rapid control of bleeding is crucial to prevent its potentially fatalconsequences.A thorough preoperative assessment and preparation for patients at risk of bleeding is essential, and this,combined with proper exposure and meticulous surgical technique, plays a key role in preventinghemorrhage. Maintaining composure and using a stepwise approach when encountering various bleedingscenarios is highly recommended.Pelvic packing is the first and most important step for temporary bleeding control, allowing for preciselocalization of the bleeding site, maintaining patient stability, and preparing for definitive treatment.Standard bleeding control techniques, such as electrocautery, suture ligation, and clips, are often ineffectivefor pelvic bleeding and may even exacerbate it.Massive pelvic hemorrhage is one of the most daunting intraoperative complications for a colorectalsurgeon. However, with the appropriate approach, it can be managed effectively.
