Efficacy and Safety of Endoscopic Clipping for Acute Anastomotic Bleeding After Colorectal Surgery
10.3393/ac.2021.00297.0042
- Author:
Ryun Kyong HA
1
;
Kyung Su HAN
;
Sung Sil PARK
;
Dae Kyung SOHN
;
Chang Won HONG
;
Byung Chang KIM
;
Bun KIM
Author Information
1. Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center, Goyang, Korea
- Publication Type:Original Article
- From:Annals of Coloproctology
2022;38(3):262-265
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:Anastomotic bleeding after colorectal surgery is a rare, mostly self-limiting, postoperative complication that could lead to a life-threatening condition. Therefore, prompt management is required. This study aimed to evaluate the efficacy and safety of endoscopic clipping for acute anastomotic bleeding after colorectal surgery.
Methods:We retrospectively reviewed the data of patients pathologically diagnosed with colorectal cancer at National Cancer Center, Korea from January 2018 to November 2020, which presented with anastomotic bleeding within the first postoperative week and were endoscopically managed with clips.
Results:Nine patients had anastomotic bleeding, underwent endoscopic management, and, therefore, were included in this study. All patients underwent laparoscopic (low/ultralow) anterior resection with mechanical double-stapled anastomosis. Anastomotic bleeding was successfully managed through a colonoscopy with clips on the first trial in all patients. Hypovolemic shock occurred in one patient, following anastomotic breakdown.
Conclusion:Endoscopic clipping seems to be an effective and safe treatment for anastomotic bleeding with minimal physiologic stress, easy accessibility, and scarce postoperative complications. However, a surgical backup should always be considered for massive bleeding.