Endoscopic Treatment of Anastomotic Bleeding in Laparoscopic Colorectal Surgery

Chirurgia (Bucur). 2019 Mar-Apr;114(2):295-299. doi: 10.21614/chirurgia.114.2.295.

Abstract

Bleeding from the stapled line is a rare but potentially lethal complication that requires a proper and immediate management. Treatment for stapled anastomotic hemorrhage may be operative or conservative. We report three cases of anastomotic stapled line bleeding after colorectal surgery successfully treated endos-copically. Laparoscopic High Anterior Resection with a trans anal anastomosis according to Knight-Griffen with circular a stapler was performed for adenocarcinoma, rectal endometriosis and diverticular disease. All three patients had major rectal bleeding within 24 hours from surgery. 1 patients had endoscopy before the end of the surgical procedure. Endoscopic wash out with removal of the clots and infiltration of the bleeding sites along the stapled line with Adrenaline 1 : 10000 (2 ml) was performed achieving a good hemostasis. Early endoscopy is a safe and efficient treatment in colorectal anastomotic bleeding.

Keywords: adrenalineinjection; anastomoticbleeding; clotwashout; colo-rectalsurgery; endoscopictreatment; laparoscopy; stapleline.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / surgery
  • Aged
  • Anastomosis, Surgical / adverse effects*
  • Colonoscopy / methods*
  • Diverticulum, Colon / surgery
  • Endometriosis / surgery
  • Epinephrine / administration & dosage
  • Female
  • Humans
  • Laparoscopy
  • Male
  • Postoperative Hemorrhage / etiology
  • Postoperative Hemorrhage / therapy*
  • Proctectomy / adverse effects*
  • Proctectomy / methods
  • Rectal Diseases / surgery*
  • Rectal Neoplasms / surgery
  • Surgical Stapling / adverse effects*
  • Therapeutic Irrigation
  • Treatment Outcome
  • Vasoconstrictor Agents / administration & dosage

Substances

  • Vasoconstrictor Agents
  • Epinephrine