Massive presacral bleeding during rectal surgery: From anatomy to clinical practice

Table 1 Adjuvant therapy for low rectal dissection in 1628 patients n (%)

Adjuvant therapy	Patients	Patients with bleeding
Rectal carcinoma	1606	2 (0.12)
Without neoadjuvant therapy	1463	2 (0.14)
With neoadjuvant radiotherapy	89	0 (0.00)
With neoadjuvant chemotherapy	29	0 (0.00)
With neoadjuvant radiochemotherapy	25	0 (0.00)
Recurrent rectal carcinoma	22	2 (9.00)
With preoperative radiotherapy	6	0 (0.00)
With preoperative chemotherapy	1	0 (0.00)
With preoperative radiochemotherapy	3	0 (0.00)
Without preoperative radiotherapy	12	2 (16.7)

Table 2 Patients with massive presacral bleeding

Patient	Sex	Age (yr)	TNM stage	Surgical procedure	Blood loss (mL)	Procedures used to control bleeding	Postoperative complication
1	Female	63	T4N0M0	AR + ileostomy	2000	Surrounding suture ligation	None
2	Male	58	T4N1M0	AR + ileostomy	800	Surrounding suture ligation	None
3	Female	69	Recurrent	AR + ileostomy	6000	Epiploic appendices welding	None
4	Female	72	Recurrent	APR	600	Epiploic appendices welding	None

TNM: Tumor-node-metastasis; AR: Anterior resection; APR: Abdominoperineal resection.