title: Use of absorbable hemostatic gauze with medical adhesive is effective for achieving hemostasis in presacral hemorrhage.
abstract: BACKGROUND
  Management of presacral hemorrhage is always challenging. Herein we describe the use of an absorbable hemostatic gauze with α-cyanoacrylate medical adhesive to achieve hemostasis.
  
  
  METHODS
  In this study, we conducted total mesorectal excision for the treatment of rectal cancer in 258 patients from March 2006 to May 2009. Intraoperative presacral hemorrhage developed in 5 (2%) patients during rectal mobilization.
  
  
  RESULTS
  In these 5 patients, massive bleeding could not be controlled by pressure and pelvic packing with gauze. An absorbable hemostatic gauze spread with medical adhesive was compressed onto the bleeding vessel for at least 20 minutes. Hemostasis was achieved successfully and was maintained during the surgery. Patients recovered uneventfully and no postoperative events were noted.
  
  
  CONCLUSIONS
  The use of an absorbable hemostatic gauze with medical adhesive is a simple and effective method for achieving hemostasis when massive presacral hemorrhage occurs. However, its effectiveness needs to be confirmed in a controlled study in a properly selected patient population.
authors.affiliation: Department of Gastrointestinopancreatic Surgery, First Affiliated Hospital of Sun Yat-Sen University, People's Republic of China.
authors.forename: Chang-Hua
authors.initials: CH
authors.lastname: Zhang
authors.forename: Xin-Ming
authors.initials: XM
authors.lastname: Song
authors.forename: Yu-Long
authors.initials: YL
authors.lastname: He
authors.forename: Fanghai
authors.initials: F
authors.lastname: Han
authors.forename: Liang
authors.initials: L
authors.lastname: Wang
authors.forename: Jian-Bo
authors.initials: JB
authors.lastname: Xu
authors.forename: Chuang-Qi
authors.initials: CQ
authors.lastname: Chen
authors.forename: Shi-Rong
authors.initials: SR
authors.lastname: Cai
authors.forename: Wen-Hua
authors.initials: WH
authors.lastname: Zhan
mesh_terms: D020341:Absorbable Implants; D000269:Adhesives / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001458:Bandages; D016063:Blood Loss, Surgical / Q000517:prevention & control; D003082:Colectomy / Q000009:adverse effects* / Q000379:methods; D003487:Cyanoacrylates / Q000494:pharmacology; D005260:Female; D005500:Follow-Up Studies; D006488:Hemostasis, Surgical / Q000379:methods; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D007431:Intraoperative Complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D012445:Sacrococcygeal Region; D012494:Sampling Studies; D016896:Treatment Outcome
chemical_list: D000269:Adhesives; D003487:Cyanoacrylates; D006490:Hemostatics