Management of lower gastrointestinal bleeding after colorectal resection and stapled anastomosis.
BACKGROUND
Although limited haematochezia with the first bowel movement is frequent in patients undergoing colorectal resection, postoperative life-threatening lower gastrointestinal bleeding is very rare. The purpose of this study was to review our results in the management of this complication.


METHODS
We analysed the cases of patients with severe lower gastrointestinal bleeding after colorectal surgery from 2000 to 2006 in our hospital. We studied the general characteristics, diagnostic data, therapeutic management and outcome. We also reviewed the published articles regarding this issue.


RESULTS
This complication appeared in 7 (0.5%) of 1,389 colorectal procedures in the study period. In all the patients the anastomosis was stapled. In six of the seven patients bleeding resolved with conservative treatment including endoscopy. However, one patient required surgical treatment. There was no mortality and there were no anastomotic leaks in these seven patients.


CONCLUSIONS
Severe lower gastrointestinal bleeding after colorectal resection and stapled anastomosis is a rare complication. Only in unstable patients or failure of conservative measures is surgery indicated.
Martínez-Serrano
Maria-Angeles
MA
Colorectal Surgery Unit, Department of Surgery, Hospital del Mar, Barcelona, Spain.
Parés
David
D
Pera
Miguel
M
Pascual
Marta
M
Courtier
Ricard
R
Egea
Maria Jose Gil
MJ
Grande
Luis
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical / Q000009:adverse effects; D003082:Colectomy / Q000009:adverse effects*; D003106:Colon / Q000601:surgery*; D003108:Colonic Diseases / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery*; D016558:Hemostasis, Endoscopic / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000601:surgery*; D012002:Rectal Diseases / Q000601:surgery; D012007:Rectum / Q000601:surgery*; D012189:Retrospective Studies; D013536:Suture Techniques / Q000009:adverse effects* / Q000295:instrumentation; D013537:Sutures; D016896:Treatment Outcome