Displacement and Per-Anal Extrusion of a Hemostatic Sacral Thumbtack

Lacerda‐Filho, Antônio; es, Leonardo C. Dur; Santos, Hernando

doi:10.1097/01.spv.0000156966.23479.81

Cited by 9 publications

(5 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Since then, their implementation has been the subject of multiple communications, most of which reported good results[ 35 - 40 ]. However, pin placement can be technically difficult[ 22 , 37 ], especially in narrow pelvises[ 41 ], when the contour of the sacrum is not sufficiently smooth and regular or when osteoporotic disease is present in the bone[ 29 , 42 ]. Failure of the technique[ 14 , 32 , 41 , 43 ], development of a presacral hematoma, chronic pelvic pain, release, migration, and perianal extrusion of the implant[ 42 ], and the need for equipment that is not always routinely available in surgery[ 14 , 24 ] are complications and inconveniences associated with the implementation of this procedure.…”

Section: Resultsmentioning

confidence: 99%

Presacral venous bleeding during mobilization in rectal cancer

Núñez¹,

Vigorita²,

Poblador³

et al. 2017

WJG

View full text Add to dashboard Cite

AIMTo analyze the anatomy of sacral venous plexus flow, the causes of injuries and the methods for controlling presacral hemorrhage during surgery for rectal cancer.METHODSA review of the databases MEDLINE® and Embase™ was conducted, and relevant scientific articles published between January 1960 and June 2016 were examined. The anatomy of the sacrum and its venous plexus, as well as the factors that influence bleeding, the causes of this complication, and its surgical management were defined.RESULTSThis is a review of 58 published articles on presacral venous plexus injury during the mobilization of the rectum and on techniques used to treat presacral venous bleeding. Due to the lack of cases published in the literature, there is no consensus on which is the best technique to use if there is presacral bleeding during mobilization in surgery for rectal cancer. This review may provide a tool to help surgeons make decisions regarding how to resolve this serious complication.CONCLUSIONA series of alternative treatments are described; however, a conventional systematic review in which optimal treatment is identified could not be performed because few cases were analyzed in most publications.

show abstract

Section: Resultsmentioning

confidence: 99%

Presacral venous bleeding during mobilization in rectal cancer

Núñez¹,

Vigorita²,

Poblador³

et al. 2017

WJG

View full text Add to dashboard Cite

show abstract

“…However, nowadays, thumbtacks are not commonly used because of difficulty in placement and reports of failure due to presacral hematomas, chronic pain, thumbtack detachment, thumbtack migration, and perianal extrusion of the plates. Also, thumbtacks may not always be available in the operating room [8,9]. Other researchers have proposed many alternatives, such as the ProTack device (Covidien, Dublin, Ireland), which attaches hemostatic sponges to the sacrum with helical endoscopic "tackers'' [10].…”

Section: Discussionmentioning

confidence: 99%

Use of a Bakri balloon in the management of presacral hemorrhage

Segarra-Vidal¹,

Rodriguez²,

Serra³

et al. 2020

J. Mol. Clin. Med.

View full text Add to dashboard Cite

Presacral hemorrhage after pelvic surgery usually results in massive, life-threatening bleeding. It is often difficult to control this presacral hemorrhage with standard hemostasis techniques after rectal mobilization. Mobilization of the rectum is part of the daily maneuvers of most pelvic surgeons. This review shows a common cause of presacral hemorrhage and demonstrates that the Bakri tamponade balloon catheter can control massive pelvic bleeding. A comprehensive, detailed review of the pelvic anatomy and hemostasis techniques used to control presacral hemorrhage was conducted. Also, a case study illustrated the novel use of the Bakri balloon for effective hemorrhage control. The presacral venous plexus or basivertebral sacral veins may be the sources of significant hemorrhage during rectal mobilization. The Bakri balloon effectively targets them. The standard recommendation for safe posterior dissection of the rectum to prevent presacral hemorrhage is approaching the plane between the mesorectal fascia and presacral fascia. We found that the Bakri balloon tamponade effectively controlled presacral hemorrhage and offers advantages over conventional packing. Massive hemorrhage is a potential complication of pelvic surgical procedures. Surgeons should be aware of hemostasis techniques for managing acute pelvic bleeding. We believe that the Bakri balloon should be included as a treatment option.

show abstract

“…The placement of sutures according to typical venous confirmation may also fail due to variations in veins and communicating veins. [ 6 ] The second type of bleeding originating from the basivertebral veins in the neural foramen is the type in which the bleeding control is most difficult. Metallic thumbtacks were first applied in basivertebral bleeding by Wang et al .…”

Section: Discussionmentioning

confidence: 99%

An Alternative Technique in the Control of Massive Presacral Rectal Bleeding: Fixation of GORE-TEX^® Aortic Patch

Özsoy¹,

Özsoy²,

Şahin³

et al. 2018

Niger J Surg

View full text Add to dashboard Cite

The presacral venous system is located under the pelvic fascia covering the anterior of the sacrum and consists of two lateral sacral veins, middle sacral vein, and the veins that communicate them. The presacral venous system can be easily damaged and causes serious bleeding which is difficult to control and may cause intraoperative mortality. Its incidence varies between 3% and 9.4%. Although several methods have been tried to control presacral bleeding, the definitive method of treatment has not yet been identified. We present here our alternative technique in control of massive presacral massive bleeding developed from the presacral plexus secondary to the traction of the specimen during the dissection. The bleeding could not be controlled despite the use of all technical possibilities such as packing, ligation, and hemostatic agents. Bleeding control was provided by GORE-TEX® graft. We conclude that fıxatıon of GORE-TEX® aortic patch should be kept in mind for uncontrolled massive presacral bleeding.

show abstract

Displacement and Per-Anal Extrusion of a Hemostatic Sacral Thumbtack

Cited by 9 publications

References 9 publications

Presacral venous bleeding during mobilization in rectal cancer

Presacral venous bleeding during mobilization in rectal cancer

Use of a Bakri balloon in the management of presacral hemorrhage

An Alternative Technique in the Control of Massive Presacral Rectal Bleeding: Fixation of GORE-TEX^® Aortic Patch

Contact Info

Product

Resources

About

Displacement and Per-Anal Extrusion of a Hemostatic Sacral Thumbtack

Cited by 9 publications

References 9 publications

Presacral venous bleeding during mobilization in rectal cancer

Presacral venous bleeding during mobilization in rectal cancer

Use of a Bakri balloon in the management of presacral hemorrhage

An Alternative Technique in the Control of Massive Presacral Rectal Bleeding: Fixation of GORE-TEX® Aortic Patch

Contact Info

Product

Resources

About

An Alternative Technique in the Control of Massive Presacral Rectal Bleeding: Fixation of GORE-TEX^® Aortic Patch