Stop the Bleeding - Endoscopic Management of Postoperative Stapled Anastomotic Site Hemorrhage in Minimal Invasive Colorectal Surgery.

IF 0.8 Q4 SURGERY
Chirurgia Pub Date : 2025-08-01 DOI:10.21614/chirurgia.3141
Bogdan Daniel Dumbravă, Florin Turcu, Cătălin Copăescu
{"title":"Stop the Bleeding - Endoscopic Management of Postoperative Stapled Anastomotic Site Hemorrhage in Minimal Invasive Colorectal Surgery.","authors":"Bogdan Daniel Dumbravă, Florin Turcu, Cătălin Copăescu","doi":"10.21614/chirurgia.3141","DOIUrl":null,"url":null,"abstract":"<p><p><b>Background:</b> Early anastomotic bleeding is a relatively understated complication of colorectal surgery. Despite intraoperative preventing protocols aiming to limit postoperative anastomotic hemorrhage, in some cases it can be dramatic. Therefore, we have decided to find out if our protocol of prompt emergency endoscopic management (Stop-the-Bleeding Protocol) is feasible, effective and safe. <b>Methods:</b> Between January, 1st 2017 and July 1st 2024, we run a prospective single-center study including all the patients who underwent colorectal resection with stapled anastomosis and experienced significant per rectum bleeding within the first 30 postoperative days. Primary outcomes were feasibility and efficacy of the endoscopic approach, related complications and mortality. <b>Results:</b> 599 patients underwent colorectal resections with mechanical anastomosis in our Center, of whom 48 patients (8%) experienced per rectum bleeding. Bleeding was encountered after all types of stapled anastomosis: recto-colic anastomoses (28 patients, 10.1%), side-to-side colo-colic anastomoses (5 patients, 3.7%) and side-to-side ileocolic anastomoses (15 patients, 8%). Hemostasis was obtained endoscopically in all the cases, mostly by only one session. No anastomotic dehiscence/leakage or fatality related to the hemorrhagic complication, or the endoscopic procedure were encountered in these series. <b>Conclusions:</b> Emergency endoscopic hemostasis for postoperative bleeding after colorectal stapled anastomosis is feasible, effective and safe.</p>","PeriodicalId":10171,"journal":{"name":"Chirurgia","volume":"120 4","pages":"403-408"},"PeriodicalIF":0.8000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Chirurgia","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.21614/chirurgia.3141","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Early anastomotic bleeding is a relatively understated complication of colorectal surgery. Despite intraoperative preventing protocols aiming to limit postoperative anastomotic hemorrhage, in some cases it can be dramatic. Therefore, we have decided to find out if our protocol of prompt emergency endoscopic management (Stop-the-Bleeding Protocol) is feasible, effective and safe. Methods: Between January, 1st 2017 and July 1st 2024, we run a prospective single-center study including all the patients who underwent colorectal resection with stapled anastomosis and experienced significant per rectum bleeding within the first 30 postoperative days. Primary outcomes were feasibility and efficacy of the endoscopic approach, related complications and mortality. Results: 599 patients underwent colorectal resections with mechanical anastomosis in our Center, of whom 48 patients (8%) experienced per rectum bleeding. Bleeding was encountered after all types of stapled anastomosis: recto-colic anastomoses (28 patients, 10.1%), side-to-side colo-colic anastomoses (5 patients, 3.7%) and side-to-side ileocolic anastomoses (15 patients, 8%). Hemostasis was obtained endoscopically in all the cases, mostly by only one session. No anastomotic dehiscence/leakage or fatality related to the hemorrhagic complication, or the endoscopic procedure were encountered in these series. Conclusions: Emergency endoscopic hemostasis for postoperative bleeding after colorectal stapled anastomosis is feasible, effective and safe.

止血-微创结直肠手术后吻合器出血的内镜治疗。
背景:早期吻合口出血是结直肠手术中一种相对被低估的并发症。尽管术中预防方案旨在限制术后吻合口出血,但在某些情况下,它可能是戏剧性的。因此,我们决定找出我们的快速急诊内镜处理方案(止血方案)是否可行、有效和安全。方法:在2017年1月1日至2024年7月1日期间,我们开展了一项前瞻性单中心研究,包括所有接受结直肠吻合术切除并在术后30天内出现明显直肠出血的患者。主要结果是内镜入路的可行性和有效性,相关并发症和死亡率。结果:599例患者行机械吻合术切除结直肠,其中48例(8%)发生直肠出血。结直肠吻合术28例(10.1%),结结肠侧侧吻合术5例(3.7%),回肠侧侧吻合术15例(8%),均发生过吻合术出血。所有病例均在内镜下止血,多数仅一次止血。在这些病例中,没有发现吻合口破裂/渗漏或与出血性并发症或内镜手术有关的死亡。结论:内镜下急诊止血治疗结直肠吻合术术后出血是可行、有效、安全的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Chirurgia
Chirurgia Medicine-Surgery
CiteScore
1.00
自引率
0.00%
发文量
75
审稿时长
4-8 weeks
期刊介绍: Chirurgia is a bimonthly journal. In Chirurgia, original papers in the area of general surgery which neither appeared, nor were sent for publication in other periodicals, can be published. You can send original articles, new surgical techniques, or comprehensive general reports on surgical topics, clinical case presentations and, depending on publication space, - reviews of some articles of general interest to surgeons from other publications. Chirurgia is also a place for sharing information about the activity of various branches of the Romanian Society of Surgery, information on Congresses and Symposiums organized by the Romanian Society of Surgery and participation notes in other scientific meetings. Letters to the editor: Letters commenting on papers published in Chirurgia are welcomed. They should contain substantive ideas and commentaries supported by appropriate data, and should not exceed 2 pages. Please submit these letters to the editor through our online system.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信