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Reoperation and Management of Postoperative Pelvic Hemorrhage and Coagulopathy

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Book cover Reoperative Pelvic Surgery

Abstract

This chapter reviews the causes of pelvic hemorrhage in the postoperative setting as well as both the surgical and nonsurgical techniques available to manage this life-threatening clinical situation. The etiology of postoperative hemorrhage directly relates to the treatment options available and the management algorithm employed. Further understanding of this topic will enable the surgeon to choose from many available techniques based on patient parameters.

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References

  1. Oderich GS, Panneton JM, Hofer J, et al. Iatrogenic operative injuries of abdominal and pelvic veins: A potentially lethal complication. J Vasc Surg. 2004;39(5):931–6.

    Article  PubMed  Google Scholar 

  2. Lepor H, Nieder AM, Ferrandino MN. Intraoperative and postoperative complications of radical retropubic prostatectomy in a consecutive series of 1,000 cases. J Urol. 2001;166(5):1729–33.

    Article  CAS  PubMed  Google Scholar 

  3. Stepp KJ, Barber MD, Yoo E-H, Whiteside JL, Paraiso MFR, Walters MD. Incidence of perioperative complications of urogynecologic surgery in elderly women. Am J Obstet Gynecol. 2005;192(5):1630–6.

    Article  PubMed  Google Scholar 

  4. Makinen J, Johansson J, Tomas C, et al. Morbidity of 10,110 hysterectomies by type of approach. Hum Reprod. 2001;16(7):1473–8.

    Article  CAS  PubMed  Google Scholar 

  5. Campagnutta E, Giorda G, De Piero G, Gallo A, Fantin D, Scarabelli C. Different patterns of postoperative bleeding following cytoreductive surgery for gynecological cancer. Eur J Gynaecol Oncol. 2000;21(1):91–4.

    CAS  PubMed  Google Scholar 

  6. Seffah JD. Re-laparotomy after cesarean section. Int J Gynaecol Obstet. 2005;88(3):253–7.

    Article  CAS  PubMed  Google Scholar 

  7. Scher KS. Unplanned reoperation for bleeding. Am Surg. 1996;62(1):52–5.

    CAS  PubMed  Google Scholar 

  8. Flordal PA. Pharmacological prophylaxis of bleeding in surgical patients treated with aspirin. Eur J Anaesthesiol Suppl. 1997;14:38–41.

    Article  CAS  PubMed  Google Scholar 

  9. Pleym H, Stenseth R, Wahba A, et al. Prophylactic treatment with desmopressin does not reduce postoperative bleeding after coronary surgery in patients treated with aspirin before surgery. Anesth Analg. 2004;98(3):578–84.

    Article  CAS  PubMed  Google Scholar 

  10. Shapiro MB, Jenkins DH, Schwab CW, Rotondo MF. Damage control: Collective review. J Trauma Inj Infect Crit Care. 2000;49(5):969–78.

    Article  CAS  Google Scholar 

  11. De Gasperi A. Intraoperative use of recombinant activated factor VII (rFVIIa). Minerva Anestesiol. 2006;72(6):489–94.

    PubMed  Google Scholar 

  12. Uhlmann EJ, Eby CS. Recombinant activated factor VII for non-hemophiliac bleeding patients. Curr Opin Hematol. 2004;11(3):198–204.

    Article  CAS  PubMed  Google Scholar 

  13. Moscardo F, Perez F, de la Rubia J, et al. Successful treatment of severe intra-abdominal bleeding associated with disseminated intravascular coagulation using recombinant activated factor VII. Br J Haematol. 2001;114(1):174–6.

    Article  CAS  PubMed  Google Scholar 

  14. White B, McHale J, Ravi N, et al. Successful use of recombinant FVIIa (Novoseven) in the management of intractable post-surgical intra-abdominal haemorrhage. Br J Haematol. 1999;107(3):677–8.

    Article  CAS  PubMed  Google Scholar 

  15. Danilo J, Goral A, Paluszkiewicz P, Przesmycki K, Kotarski J. Successful treatment with recombinant factor VIIa for intractable bleeding at pelvic surgery. Obstet Gynecol. 2003;101(6):1172–3.

    Article  Google Scholar 

  16. Hedner U. Mechanism of action of factor VIIa in the treatment of coagulopathies. Semin Thromb Hemost. 2006;32 Suppl 1:77–85.

    Article  CAS  PubMed  Google Scholar 

  17. Khan AZ, Parry JM, Crowley WF, et al. Recombinant factor VIIa for the treatment of severe postoperative and traumatic hemorrhage. Am J Surg. 2005;189(3):331–4.

    Article  CAS  PubMed  Google Scholar 

  18. Kaufman JD, Lepor H. Reoperation versus observation in men with major bleeding after radical retropubic prostatectomy. Urology. 2005;66(3):561–5.

    Article  PubMed  Google Scholar 

  19. Naylor A. Analysis of 2901 personally performed procedures. S Afr Med J. 1984;65:242–5.

    CAS  PubMed  Google Scholar 

  20. Zorn KC, Daigle S, Belzile F, Tu LM. Embolization of a massive retropubic hemorrhage following a tension-free vaginal tape (TVT) procedure: case report and literature review. Can J Urol. 2005;12(1):2560–3.

    PubMed  Google Scholar 

  21. Rosenthal DM, Colapinto R. Angiographic arterial embolization in the management of postoperative vaginal hemorrhage. Am J Obstet Gynecol. 1985;151(2):227–31.

    CAS  PubMed  Google Scholar 

  22. Poulakis V, Ferakis N, Becht E, Deliveliotis C, Duex M. Treatment of renal-vascular injury by transcatheter embolization: Immediate and long-term effects on renal function. J Endourol. 2006;20(6):405–9.

    Article  PubMed  Google Scholar 

  23. Spinosa DJ, Angle JF, McGraw JK, Maurer EJ, Hagspiel KD, Matsumoto AH. Transcatheter treatment of life-threatening lower gastrointestinal bleeding due to advanced pelvic malignancy. Cardiovasc Intervent Radiol. 1998;21(6):503–5.

    Article  CAS  PubMed  Google Scholar 

  24. Inaba Y, Arai Y, Ino S, Matsueda K, Aramaki T, Takaki H. Transcatheter arterial embolization for external iliac artery hemorrhage associated with infection in postoperative pelvic malignancy. J Vasc Interv Radiol. 2004;15(3):283–7.

    PubMed  Google Scholar 

  25. Kim J, Kim J-K, Yoon W, et al. Transarterial embolization for postoperative hemorrhage after abdominal surgery. J Gastrointest Surg. 2005;9(3):393–9.

    Article  PubMed  Google Scholar 

  26. Hansch E, Chitkara U, McAlpine J, El-Sayed Y, Dake MD, Razavi MK. Pelvic arterial embolization for control of obstetric hemorrhage: a five-year experience [see comment]. Am J Obstet Gynecol. 1999;180(6 Pt 1):1454–60.

    Article  CAS  PubMed  Google Scholar 

  27. Burchell RC. Physiology of internal iliac artery ligation. J Obstet Gynaecol Br Commonw. 1968;75(6):642–51.

    Article  CAS  PubMed  Google Scholar 

  28. Wells I. Internal iliac artery embolization in the management of pelvic bleeding [see comment]. Clin Radiol. 1996;51(12):825–7.

    Article  CAS  PubMed  Google Scholar 

  29. Papp Z, Toth-Pal E, Papp C, et al. [Bilateral hypogastric artery ligation for control of pelvic hemorrhage, reduction of blood flow and preservation of reproductive potential. Experience with 117 cases]. Orv Hetil. 2005;146(24):1279–85.

    PubMed  Google Scholar 

  30. Tomacruz RS, Bristow RE, Montz FJ. Management of pelvic hemorrhage. Surg Clin North Am. 2001;81(4):925–48.

    Article  CAS  PubMed  Google Scholar 

  31. Carless PA, Henry DA, Anthony DM. Fibrin sealant use for minimising peri-operative allogeneic blood transfusion. Cochrane Database Syst Rev. 2003;(2):CD004171.

    Google Scholar 

  32. Oz MC, Cosgrove DM, 3rd, Badduke BR, et al. Controlled clinical trial of a novel hemostatic agent in cardiac surgery. The Fusion Matrix Study Group. Ann Thorac Surg. 2000;69(5):1376–82.

    Article  CAS  PubMed  Google Scholar 

  33. Dietrich W, Spath P, Ebell A, Richter JA. Prevalence of anaphylactic reactions to aprotinin: analysis of two hundred forty-eight reexposures to aprotinin in heart operations. J Thorac Cardiovasc Surg. 1997;113(1):194–201.

    Article  CAS  PubMed  Google Scholar 

  34. Sarfati MR, Dilorenzo DJ, Kraiss LW, Galt SW. Severe coagulopathy following intraoperative use of topical thrombin. Ann Vasc Surg. 2004;18(3):349–51.

    Article  PubMed  Google Scholar 

  35. Hill AD, Menzies-Gow N, Darzi A. Methods of controlling presacral bleeding [see comment]. J Am Coll Surg. 1994;178(2):183–4.

    CAS  PubMed  Google Scholar 

  36. Harma M, Harma M. The use of thumbtacks to stop severe presacral bleeding: a simple, effective, readily available and potentially life-saving technique [see comment]. Eur J Gynaecol Oncol. 2005;26(4):466; author reply 467; discussion 467.

    CAS  PubMed  Google Scholar 

  37. Ayuste E Jr, Roxas MFT. Validating the use of rectus muscle fragment welding to control presacral bleeding during rectal mobilization. Asian J. 2004;27(1):18–21.

    Google Scholar 

  38. Civelek A, Yeen C, Aktan AO. The use of bonewax to control massive presacral bleeding. Surgery Today. 2002;32(10):944–5.

    Google Scholar 

  39. Losanoff JE, Richman BW, Jones JW. Cyanoacrylate adhesive in management of severe presacral bleeding. Dis Colon Rectum. 2002;45(8):1118–9.

    Article  PubMed  Google Scholar 

  40. Sharp KW, Locicero RJ. Abdominal packing for surgically uncontrollable hemorrhage. Ann Surg. 1992; 215(5):467–74; discussion 74–5.

    Article  CAS  PubMed  Google Scholar 

  41. Young N, Gerson, SL, High Katherine A. Clinical hematology. Philadelphia: Mosby/Elvesier; 2006.

    Google Scholar 

  42. Hinman F Jr. Atlas of Urosurgical Anatomy. Philadelphia: W.B. Saunders; 1993.

    Google Scholar 

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Young, J.L., Lachance, J.A., Rice, L.W., Foley, E.F. (2009). Reoperation and Management of Postoperative Pelvic Hemorrhage and Coagulopathy. In: Billingham, R., Kobashi, K., Peters, W. (eds) Reoperative Pelvic Surgery. Springer, New York, NY. https://doi.org/10.1007/b14187_3

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  • DOI: https://doi.org/10.1007/b14187_3

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-0-387-89998-5

  • Online ISBN: 978-0-387-89999-2

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