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OBJECTIVE: Bleeding from stapled colonic stapled anastomoses is rare, but occasionally may be severe enough to require re-operation, with associated morbidity. Endoscopic therapy is a potential alternative. METHOD: We examined a large 15-year prospective series of patients who had undergone colorectal resection with stapled anastomosis. We reviewed the management of cases where severe postoperative rectal bleeding had occurred. RESULTS: In six of 777 (0.8%) patients, bleeding occurred that was severe enough to require intervention. In the first three cases, conventional re-operation was performed. In the latter three cases, endoscopic therapy (adrenaline injection, diathermy or endoscopic clipping) was used to control the bleeding. No complications occurred as a result of endoscopic therapy, either patient or anastomosis related. CONCLUSION: Endoscopic management using standard endoscopic techniques appears safe and effective for haemostasis in colorectal stapled anastomotic bleeding. Endoscopic therapy should probably be attempted before re-operation is considered.

Original publication

DOI

10.1111/j.1463-1318.2007.01459.x

Type

Journal article

Journal

Colorectal Dis

Publication Date

07/2008

Volume

10

Pages

616 - 618

Keywords

Adult, Aged, Aged, 80 and over, Colon, Diathermy, Epinephrine, Female, Hemorrhage, Hemostasis, Endoscopic, Humans, Male, Postoperative Complications, Prospective Studies, Rectum, Reoperation, Sutures