Systematic Reviews
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 7, 2017; 23(9): 1712-1719
Published online Mar 7, 2017. doi: 10.3748/wjg.v23.i9.1712
Presacral venous bleeding during mobilization in rectal cancer
Jose Enrique Casal Núñez, Vincenzo Vigorita, Alejandro Ruano Poblador, Ana María Gay Fernández, Maria Ángeles Toscano Novella, Nieves Cáceres Alvarado, Lucinda Pérez Dominguez
Jose Enrique Casal Núñez, Vincenzo Vigorita, Alejandro Ruano Poblador, Ana María Gay Fernández, Maria Ángeles Toscano Novella, Nieves Cáceres Alvarado, Lucinda Pérez Dominguez, Coloproctology Unit and General and Digestive Surgery Unit, Vigo University Hospital Complex, 36212 Vigo, Spain
Author contributions: All authors contributed equally to this work, designed and performed the research, and analyzed the data; Casal Núñez JE conceptualized and designed the review and drafted the initial manuscript; all authors reviewed and approved the final manuscript as submitted.
Conflict-of-interest statement: No potential conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Vincenzo Vigorita, Coloproctology Unit and General and Digestive Surgery Unit, Vigo University Hospital Complex, Planta 1, Vela D, Estrada Clara Campoamor 341, 36212 Vigo, Spain. v.vigorita@gmail.com
Telephone: +34-630-837456 Fax: +34-986-811111
Received: December 23, 2016
Peer-review started: December 23, 2016
First decision: January 10, 2017
Revised: January 26, 2017
Accepted: February 16, 2017
Article in press: February 17, 2017
Published online: March 7, 2017
Processing time: 73 Days and 10.8 Hours
Abstract
AIM

To analyze the anatomy of sacral venous plexus flow, the causes of injuries and the methods for controlling presacral hemorrhage during surgery for rectal cancer.

METHODS

A 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.

RESULTS

This 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.

CONCLUSION

A 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.

Keywords: Presacral hemorrhaging; Rectal surgery; Sacral venous plexus; Pelvic surgery; Sacral anatomy

Core tip: This 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. We believe that this work is potentially relevant to helping surgeons understand the physiopathology of this complication and making them aware of possible surgical strategies for its treatment.