Efficacy of rectus muscle fragment welding in the control of presacral venous bleeding

Background The incidence of presacral venous bleeding during rectal resection is low, but this complication can be severe and even lethal. Occasionally, the traditional methods – such as pelvic gauze packing and the use of metallic thumbtacks – are not effective. When combined with their complications and difficulties, these failures have resulted in numerous creative procedures with which to control this complication. In 1994, the indirect electrocoagulation method, which is performed via a fragment of the rectus abdominis muscle of the abdomen, was introduced to control presacral venous bleeding. Methods From January 2002 to December 2015, five of 872 patients with rectal cancer and one patient with rectal metastasis of gastric cancer developed presacral venous bleeding, and this technique was used in every case. Results Haemostasis was permanent in all cases. There were no complications such as infection or rebleeding. Conclusion In our experience, indirect electrocoagulation via a fragment of the rectus abdominis muscle of the abdomen is a rapid, easily executed and effective method for controlling presacral venous bleeding during rectal resection.