The Use of Ligating Clips (Liga Clips®) to Control Massive Presacral Venous Bleeding
Keywords:
Ligating clips, Liga clips, vascular clip, massive presacral venous bleeding, pelvic packingAbstract
Background: Massive presacral venous bleeding is a serious complication that the hemostatic methodscommonly performed may be ineffective. The author presents the use of the ligating clips , another method,
in controlling massive presacral venous bleeding in failure cases from many hemostatic methods.
Method: During the 5 year period of 2001-2005, there were 142 pelvic surgical cases. Most of them were
malignancy and the common procedure performed was low anterior resection. There were 3 cases of massive
presacral venous bleeding that could not be controlled by conventional hemostatic methods. These cases were
recurrence cancer of rectum, advanced rectal cancer with liver cirrhosis and huge retrorectal tumor.
Result: There were 3 patients who failed from previous operation in attempt to control bleeding by
electric cautery, argon plasma coagulator, muscle welding technique and finally pelvic packing. All of them were
successfully controlled by ligating clip. There were no postoperative bleedings or infections, and no further
blood transfusion was needed.
Conclusion: Ligating clips, a basic instrument available in all hospitals, is effective in controlling
massive presacral venous bleeding.
References
1. Pollard CW, Nivatvongs S, Rojansakul A, Ilstrup DM.
Carcinoma of the rectum. Profiles of intraoperative and
early postoperative complications. Dis Colon Rectum 1994;
37:866-74.
2. Krause U, Pahlman L, Phoren L. Abdominoperineal excision.
World J Surg 1982;6:549-53.
3. Wang QY, Shi WJ, Zhao YR, Zhou WQ, He ZR. New concepts
in severe presacral hemorrhage during proctectomy. Arch
Surg 1985;120:1013-20.
4. Nivatvongs S, Fang DT. The use of thumbtacks to stop
massive presacral hemorrhage. Dis Colon Rectum 1986;29:
589-90.
5. Timmons MC, Kohler MF, Addison WA. Thumbtack use for
control of presacral bleeding, with description of an
instrument for thumbtack application. Obstet Gynecol
1991;78:313-5.
6. Stolfi VM, Milsom JW, Lavery IC, Oakley JR, Church JM, Fazio
VW. Newly designed occluder pin for presacral hemorrhage.
Dis Colon Rectum 1992;35:166-9.
7. Cosman BC, Lackides GA, Fischer DP, Eskenazi LB. Use of
tissue expander for tamponade of presacral hemorrhage.
Dis Colon Rectum 1994;37:723-6.
8. Basso L. Balloon tamponade for control of massive presacral
haemorrhage. Br J Surg 1996 ;83:866-7.
9. McCourtney JS, Hussain N, MacKenzie I. Balloon tamponade
for control of massive presacral haemorrhage. Br J Surg
1996;83:222.
10. Braley SC, Schneider PD, Bold RJ, Goodnight JE Jr, Khatri VP.
Controlled tamponade of severe presacral venous
hemorrhage: use of a breast implant sizer. Dis Colon Rectum
2002;45:140-2.
11. Zama N, Fazio VW, Jagelman DG, et al. Efficacy of pelvic
packing in maintaining hemostasis after rectal excision of
cancer. Dis Colon Rectum 1988;31:923-8.
12. Xu J, Lin J. Control of presacral hemorrhage with electrocautery
through a muscle fragment pressed on the bleeding
vein. J Am Coll Surg 1994;179:351-2.
13. Harrison JL, Hooks VH, Pearl RK, Cheape JD, Lawrence MA,
Orsay CP, Abcarian H. Muscle fragment welding for control
of massive presacral bleeding during rectal mobilization: a
review of eight cases. Dis Colon Rectum 2003;46:1115-7.
14. Remzi FH, Oncel M, Fazio VW. Muscle tamponade to control
presacral venous bleeding: report of two cases. Dis Colon
Rectum 2002;45:1109-11.
15. Civelek A, Yegen C, Aktan AO. The use of bonewax to
control massive presacral bleeding. Surg Today 2002;32:944-
5.
16. Losanoff JE, Richman BW, Jones JW. Cyanoacrylate
adhesive in management of severe presacral bleeding. Dis
Colon Rectum 2002;45:1118-9.
Carcinoma of the rectum. Profiles of intraoperative and
early postoperative complications. Dis Colon Rectum 1994;
37:866-74.
2. Krause U, Pahlman L, Phoren L. Abdominoperineal excision.
World J Surg 1982;6:549-53.
3. Wang QY, Shi WJ, Zhao YR, Zhou WQ, He ZR. New concepts
in severe presacral hemorrhage during proctectomy. Arch
Surg 1985;120:1013-20.
4. Nivatvongs S, Fang DT. The use of thumbtacks to stop
massive presacral hemorrhage. Dis Colon Rectum 1986;29:
589-90.
5. Timmons MC, Kohler MF, Addison WA. Thumbtack use for
control of presacral bleeding, with description of an
instrument for thumbtack application. Obstet Gynecol
1991;78:313-5.
6. Stolfi VM, Milsom JW, Lavery IC, Oakley JR, Church JM, Fazio
VW. Newly designed occluder pin for presacral hemorrhage.
Dis Colon Rectum 1992;35:166-9.
7. Cosman BC, Lackides GA, Fischer DP, Eskenazi LB. Use of
tissue expander for tamponade of presacral hemorrhage.
Dis Colon Rectum 1994;37:723-6.
8. Basso L. Balloon tamponade for control of massive presacral
haemorrhage. Br J Surg 1996 ;83:866-7.
9. McCourtney JS, Hussain N, MacKenzie I. Balloon tamponade
for control of massive presacral haemorrhage. Br J Surg
1996;83:222.
10. Braley SC, Schneider PD, Bold RJ, Goodnight JE Jr, Khatri VP.
Controlled tamponade of severe presacral venous
hemorrhage: use of a breast implant sizer. Dis Colon Rectum
2002;45:140-2.
11. Zama N, Fazio VW, Jagelman DG, et al. Efficacy of pelvic
packing in maintaining hemostasis after rectal excision of
cancer. Dis Colon Rectum 1988;31:923-8.
12. Xu J, Lin J. Control of presacral hemorrhage with electrocautery
through a muscle fragment pressed on the bleeding
vein. J Am Coll Surg 1994;179:351-2.
13. Harrison JL, Hooks VH, Pearl RK, Cheape JD, Lawrence MA,
Orsay CP, Abcarian H. Muscle fragment welding for control
of massive presacral bleeding during rectal mobilization: a
review of eight cases. Dis Colon Rectum 2003;46:1115-7.
14. Remzi FH, Oncel M, Fazio VW. Muscle tamponade to control
presacral venous bleeding: report of two cases. Dis Colon
Rectum 2002;45:1109-11.
15. Civelek A, Yegen C, Aktan AO. The use of bonewax to
control massive presacral bleeding. Surg Today 2002;32:944-
5.
16. Losanoff JE, Richman BW, Jones JW. Cyanoacrylate
adhesive in management of severe presacral bleeding. Dis
Colon Rectum 2002;45:1118-9.
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Published
2009-06-30
How to Cite
1.
Jivapaisarnpong P. The Use of Ligating Clips (Liga Clips®) to Control Massive Presacral Venous Bleeding. Thai J Surg [Internet]. 2009 Jun. 30 [cited 2024 Nov. 23];30(1-2). Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/227667
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