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.

译文

盆腔手术中由骶前静脉丛引起的出血难以控制,构成潜在的危及生命的并发症。尽管已建立了缝合结扎,包装和大头钉的止血技术,但通常被证明是无效的。我们报告了一种使用喷雾透热疗法来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四名患者,其中两名接受低位前切除术,另一名接受腹部会阴直肠癌切除术,这些患者在直肠动员过程中表现出严重的骶前出血。在喷雾设置下,在骶前筋膜的目标出血器上方稍稍施加电灼,并结合引流抽吸,提供高频电流。在所有情况下,该方法均成功止血。应用喷雾电灼术是一种简单有效的控制骶前出血的方法。使用这种方法代替常规止血技术的优点包括通过改变电流的频率和体积来改变止血效果的程度。

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