title: Short-term clinical outcomes of postoperative intrapelvic bleeding after extended pelvic surgery: a single institute experience.
abstract: OBJECTIVE
  Intrapelvic bleeding after extended pelvic surgery is fatal, but few reports have addressed this serious situation. The objective of the present study was to evaluate the short-term clinical outcome of this complication.
  
  
  METHODS
  This study was a retrospective medical chart review of 130 patients who underwent extended pelvic surgery between 2000 and 2012 at our Institute. Based on the classification of the bleeding pelvic artery, how initial hemostasis and control of secondary pelvic abscess were mainly evaluated.
  
  
  RESULTS
  In 6 patients, bleeding involved a peripheral artery (peripheral group) and 4 a main artery (central group). For initial hemostasis, interventional radiology was efficacious. Compared to the peripheral group, even if initial hemostasis succeeded, unsatisfactory abscess drainage easily became fatal in the central group.
  
  
  CONCLUSIONS
  Aggressive surgical abscess drainage should be considered at an appropriate time for optimal survival in patients with involvement of a main artery with insufficient tube drainage.
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita City, Osaka, Japan.
authors.forename: Hisataka
authors.initials: H
authors.lastname: Ogawa
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita City, Osaka, Japan tmizushima@gesurg.med.osaka-u.ac.jp.
authors.forename: Tsunekazu
authors.initials: T
authors.lastname: Mizushima
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita City, Osaka, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Takemasa
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita City, Osaka, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Yamamoto
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita City, Osaka, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Doki
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita City, Osaka, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000209:etiology*; D009367:Neoplasm Staging; D010386:Pelvic Neoplasms / Q000150:complications / Q000556:secondary / Q000601:surgery*; D019106:Postoperative Hemorrhage / Q000175:diagnosis / Q000209:etiology*; D011379:Prognosis; D012004:Rectal Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies
keywords: Postoperative complication; extended pelvic surgery; intrapelvic bleeding